A  TEXT-BOOK 


OF  THE 


DISEASES  OF  THE  SMALL 
DOMESTIC  ANIMALS 


BY 
OSCAR  VICTOR  BRUMLEY,  V.S. 

PROFESSOR    OF    VETERINARY    SURGERY   AND    DIRECTOR    OF    CLINICS,    COLLEGE 

OF  VETERINARY  MEDICINE,  OHIO  STATE  UNIVERSITY, 

COLUMBUS,  OHIO 


LEA  &  FEBIGER 

PHILADELPHIA   AND  NEW   YORK 


14S417 


COPYRIGHT 
LEA  &  FEBIGER 

1921 


PRINTED  IN  U.  S.  A. 


PREFACE. 


THIS  book  is  intended  to  be  a  practical  text  on  the  Diseases 
of  the  Small  Domestic  Animals.  The  author  feels  that  it  is 
inadvisable  to  write  an  exhaustive  treatise  on  this  subject, 
as  it  is  primarily  intended  to  be  a  book  for  student  use  and  for 
the  busy  practitioner.  An  attempt  has  been  made  to  include 
most  of  the  important  diseases  (medical  and  surgical)  of 
small  animals  with  which  the  veterinarian  comes  in  contact. 
It  is  hoped  that  it  will  serve  the  purpose  for  which  it  is  written. 

The  author  does  not  claim  originality  for  all  the  material 
in  the  book.  The  literature  and  standard  books  have  been 
consulted  freely. 

For  scientific  reasons  the  metric  system  has  been  used 
throughout  the  text.  A  table  of  equivalents  in  weights  and 
measures  has  been  inserted  so  that  the  dosage  can  be  readily 
determined  in  the  other  system,  if  desired.  This  was  thought 
to  be  more  desirable  than  including  both  under  the  treatment 
of  each  disease. 

The  author  wishes  to  express  his  appreciation  for  the 
valued  assistance  rendered  by  his  colleagues  in  the  College 
of  Veterinary  Medicine,  Ohio  State  University,  in  the 
preparation  of  the  manuscript.  He  is  especially  indebted 
to  Colonel  David  S.  White,  Dean,  for  his  kindness  in  arrang- 
ing and  correcting  the  manuscript,  and  for  his  advice  relative 
to  the  subject  matter,  and  in  many  other  ways  contributing 
to  the  value  of  the  book.  Also  to  Dr.  James  Howard  Snook 


iv  PREFACE 

for  suggestions  in  the  chaptep  on  skin  diseases  and  various 
other  problems  as  they  presented  themselves.  The  author's 
thanks  are  extended  to  Dr.  John  Newton  Shoemaker  and 
others  who  have  been  liberal  with  their  assistance  during  the 

preparation  of  the  manuscript. 

O.  V.  B. 

Columbus,  Ohio,  1921. 


CONTENTS. 

PART  I. 
DISEASES  OF  THE  RESPIRATORY  SYSTEM. 

CHAPTER  I. 

DISEASES  OF  THE  NASAL  PASSAGES. 

Examination 17 

Acute  Nasal  Catarrh  (Coryza.     Rhinitis) 19 

Empyema  of  the  Infraorbital  Fossae  of  Birds 20 

Infectious  Nasal  Catarrh  of  Rabbits  (Rabbit  Plague.     Rabbit 

Influenza.     Rabbit  Distemper) 20 

Parasitic  Nasal  Catarrh  of  Rabbits  (Rhinitis  Coccidiosa) ...  22 

Chronic  Nasal  Catarrh  (Chronic  Coryza.      Rhinitis)    ....  23 

Epistaxis        .  ....  24 

Parasites  of  the  Nasal  Passages 25 

Neoplasms  of  the  Nasal  Passages 28 

Papillomata 28 

Polypoid  Fibromata 28 

Malignant  Tumors 29 

CHAPTER  II. 

DISEASES  OF  THE  LARYNX. 

Acute  Laryngitis 30 

Chronic  Laryngitis 31 

CHAPTER  III. 

DISEASES  OF  THE  TRACHEA  AND  BRONCHIAL  TUBES. 

Examination 34 

Acute  Tracheitis  and  Bronchitis 34 

Bronchial  Catarrh  of  Birds  (Bronchitis) 38 

Mycotic  Pneumonia  (Aspergillosis) 40 

Animal  Parasites  in  the  Trachea  and  Bronchial  Tubes  (Syngamosis. 

Gapes  in  Chickens) 42 

Chronic  Tracheitis  and  Bronchitis  44 


vi  CONTENTS 

CHAPTER  IV. 

DISEASES  OF  THE  LUNGS. 

Examination 47 

Congestion  of  the  Lungs  (Hyperemia  of  the  Lungs)     ....  49 

Active  Congestion 49 

Passive  Congestion 50 

Pulmonary  Edema  (Edema  of  the  Lungs) 52 

Bronchopneumonia  (Catarrhal  Pneumonia) 53 

Cirrhosis  of  the  Lungs  (Chronic  Interstitial  Pneumonia)   ...  57 

Foreign  Body  Pneumonia  (Gangrene  of  the  Lungs)       ....  58 

CHAPTER  V. 

DISEASES  OF  THE  PLEURA. 

Pleuritis  (Pleurisy)  '....• 60 

Hydrothorax       .  65 

Pneumothorax 66 

Hemothorax  .  67 


PART  II. 
DISEASES  OF  THE  CIRCULATORY  SYSTEM. 

CHAPTER  I. 

DISEASES  OF  THE  PERICARDIUM. 

Examination 69 

Pericarditis .  73 

Hydropericardium  (Dropsy  of  the  Pericardium) 76 

Hemopericardium 77 

CHAPTER  II. 

DISEASES  OF  THE  HEART. 

Valvular  Insufficiency  and  Stenosis 78 

Myocarditis 82 

Acute  Myocarditis 82 

Chronic  Myocarditis 84 

Acute  Endocarditis 85 

Hypertrophy  and  Dilatation  of  the  Heart 89 

Rupture  of  the  Heart    .  92 


CONTENTS  vii 

i 

PART  III. 
DISEASES  OF  THE  DIGESTIVE  TRACT. 

CHAPTER  I. 

DISEASES  OF  THE  MOUTH. 

Examination 93 

Stomatitis 94 

Catarrhal  Stomatitis 94 

Ulcerative  Stomatitis 96 

Gangrenous  Stomatitis  (Canker  of  the  Mouth)  ....  97 

Phlegmonous  Stomatitis 99 

Parasitic  Sto  natitis  (Thrush.  Soor.  Aphtha)  ....  100 

Benign  Neoplasms  of  the  Mouth 102 

Papillomata 102 

Fibromata 102 

Osteoma 103 

Retention  Cysts  (Ranula) 103 

Malignant  Neoplasms  of  the  Mouth 104 

Epitheliomata 104 

Sarcomata 105 

Foreign  Bodies  in  the  Mouth  .            106 

CHAPTER  II. 

DISEASES  OF  THE  TEETH. 

Examination 107 

Malformations  of  the  Teeth 107 

Fractures  of  the  Teeth ' 108 

Incrustations  of  Tartar 108 

Alveolar  Periostitis  (Pericementitis.     Periodontrtis)      ....  108 

Caries  of  the  Teeth 109 

CHAPTER  III. 

DISEASES  OF  THE  TONGUE. 

Examination Ill 

Glossitis Ill 

Gangrene  of  the  Tongue  (Gangrenous  Glossitis)       .           ...  1 12 


viii  CONTENTS 


CHAPTER  IV. 

DISEASES  OF  THE  SALIVARY  GLANDS. 

Examination 115 

Parotitis  (Mumps) 115 

Submaxillary  and  Sublingual  Glands 118 

Salivary  Fistula 118 

CHAPTER  V. 

DISEASES  OF  THE  TONSILS. 

Examination         .      .          .  120 

Tonsillitis  and  Lymphadenitis 120 

CHAPTER  VI. 

DISEASES  OF  THE  PHARYNX. 

Examination 123 

Pharyngitis    ....  123 

Acute  Pharyngitis 123 

Chronic  Pharyngitis 125 

Foreign  Bodies  in  the  Pharynx      .' .  126 

Paralysis  of  the  Pharynx     .  127 

Croupous  Pharyngitis  of  Birds 127 

Neoplasms  of  the  Pharynx 128 

Polypoid  Growths 128 

Epithelioma      .  129 

CHAPTER  VII. 

DISEASES  OF  THE  ESOPHAGUS. 

Examination 130 

Esophagitis 130 

Foreign  Bodies  (Obstruction  in  Esophagus) 131 

Esophagismus 135 

Stricture  of  the  Esophagus : 135 

Dilatations  and  Diverticula  of  the  Esophagus 136 

Catarrh  of  the  Crop  in  Birds  (Soft  Crop) 137 

Obstruction  of  the  Crop  in  Birds  (Hard  Crop) 139 

Neoplasms  of  the  Esophagus 141 


CONTENTS  ix 

CHAPTER  VIII. 

DISEASES  OF  THE  STOMACH. 

Examination 142 

Gastritis 142 

Acute  Gastritis    (Simple  Catarrh    of    the    Stomach.     Acute 

Dyspepsia) 142 

Chronic  Gastritis  (Chronic  Catarrh  of  the  Stomach.     Chronic 

Dyspepsia) 146 

Foreign  Bodies  in  the  Stomach 148 

Acute  Dilatation  of  the  Stomach 152 

Chronic  Dilatation  of  the  Stomach 154 

Ulceration  of  the  Stomach  (Ulcus  Ventriculi) 157 

Hematemesis 160 

Parasites  in  the  Stomach 163 

Neoplasms  in  the  Stomach.      .      .' 165 

CHAPTER  IX. 

DISEASES  OF  THE  INTESTINES. 

Examination 167 

Enteritis 167 

Acute  Enteritis 167 

Chronic  Enteritis 173 

Intestinal  Hemorrhage  (Enterorrhagia) 175 

Diarrhea 178 

Constipation  (Obstipation.     Intestinal  Obstruction)    ....  182 

Volvulus " 185 

Intussusception 186 

Wounds  of  the  Intestines 188 

Croupous  Enteritis  of  Cats  (Membranous  Enteritis)     ....  190 

Infectious  Asthenia  of  Birds 191 

CHAPTER  X. 

PARASITES  IN  THE  INTESTINES. 

Helminthiasis 193 

Tseniasis  (Cestoda) 193 

Tsenise  in  Dogs 195 

Tseniae  in  the  Intestine  of  the  Cat 197 

Ta3nia3  in  the  Intestine  of  Rabbits 197 

Taeniae  in  the  Intestines  of  Birds  .  198 


x  CONTENTS 

Nematoda 201 

Round  worms  (Ascaridse)        .      .      .      ."     . 201 

Round  Worms  in  the  Intestine  of  the  Dog 202 

Round  Worms  in  the  Intestine  of  the  Cat       ....  202 

Round  Worms  in  the  Intestine  of  the  Rabbit       .      .      .  202 

Round  Worms  in  the  Intestine  of  Birds 202 

StrongylidsE  (Hookworm)        .      .      . 206 

Strongylidtc  in  the  Intestine  of  the  Dog 207 

Strongylidir  in  the  Intestine  of  the  Cat 207 

Strongylidie  in  the  Intestine  of  the  Rabbit      ....  207 

Trichinellidse  (Whipworm) 209 

Trichinellidjc  in  the  Intestine  of  the  Dog 210 

Trichinellidav  in  the  Intestine  of  the  Rabbit    ....  210 

Trichinellidse  in  the  Intestine  of  Birds 210 

CHAPTER  XI. 

DISEASES  OF  THE  RECTUM  AND  ANUS. 

Examination 212 

Occlusion  of  the  Rectum  and  Anus .  212 

Proctitis 214 

Hemorrhoids  (Piles) 216 

Prolapse  of  the  Rectum 217 

Parasites  in  the  Rectum 221 

Neoplasms  in  the  Rectum  . 222 

Suppuration  of  the.  Anal  Glands 223 

CHAPTER  XII. 

DISEASES  OF  THE  LIVER. 

Examination 225 

Icterus  (Jaundice) 225 

Congestion  of  the  Liver 231 

Active  Congestion 231 

Passive  Congestion 233 

Hepatitis 235 

Suppurative  Hepatitis  (Abscess  of  the  Liver)    .....  236 

Atrophy  of  the  Liver 240 

Fatty  Liver 241 

Amyloid    Liver 242 

Cirrhosis  of  the  Liver  (Chronic  Interstitial  Hepatitis)  ....  243 

Neoplasms  of  the  Liver 244 

Cholelithiasis.     Gall-stones 245 

Rupture  of  the  Liver   (Ruptura  Hepatis.     Apoplexia  Hepatis)    .  246 


CONTENTS  xi 

CHAPTER  XIII. 

DISEASES  OF  THE  PERITONEUM 

General  Remarks 248 

Peritonitis 250 

Acute  Peritonitis 250 

Chronic  Peritonitis 255 

Ascites      (Hydrops       Abdominis.     Hydrops    Ascites.     Hydrops 

Peritonei) .                                                                                          .  257 


PART  IV. 
DISEASES  OF  THE  REPRODUCTIVE  ORGANS. 

CHAPTER  I. 

DISEASES  OF  THE  PENIS  AND  PREPUCE. 

Examination 263 

Wounds  of  the  Penis  and  Prepuce 263 

Congenital  Malformations 265 

Preputial  Catarrh  (Balanitis)  .      .      .      . 265 

Phimosis 266 

Paraphimosis 267 

Tumors  of  the  Penis  and  Prepuce                   .    " 268 

Papillomata 269 

Sarcomata,  Epitheliomata  and  Carcinomata     .      .      .      .      .  269 

Venereal  Granulomata 269 

CHAPTER  -II. 

DISEASES  OF  THE  TESTES  AND  SCROTUM. 

Wounds  and  Injuries  of  the  Testes  and  Scrotum 271 

Orchitis    ....            ..............  271 

Tumors  of  the  Scrotum  and  Testes 272 

Parasites  in  the  Scrotum  and  Testes  (Cuterebra  Emasculator)  273 

Castration   (Orchectomy) 273 

Castration  of  the  Dog       . .      .      .  274 

Castration  of  the  Monorchid  and  Cryptorchid  Dog  .      .  275 

Castration  of  the  Cat 275 

Castration  of  Birds  (Caponizing) 276 


xii  CONTENTS 

CHAPTER  III.. 

DISEASES  OF  THE  PROSTATE  GLAND. 

Examination 279 

Prostatitis 279 

Tumors  of  the  Prostate  Gland  (Hypertrophy  of  the  Prostate 

Gland) 280 

CHAPTER  IV. 

DISEASES  OF  THE  OVARIES. 

Examination 283 

Inflammation  of  the  Ovaries  (Oophoritis) 283 

Tumors  of  the  Ovaries 284 

Cysts 284 

Oophorectomy  (Ovariectomy) 285 

Oophorectomy  in  the  Dog 286 

Oophorectomy  in  the  Cat 289 

Poulardizing  the  Female  Chicken 289 

CHAPTER  V. 

DISEASES  OF  THE  UTERINE  TUBES. 

Examination 291 

Salpingitis 291 

Pyosalpinx 291 

Tumors  (Cysts) 291 

CHAPTER  VI. 

DISEASES  OF  THE  UTERUS. 

Examination 292 

Metritis 293 

Acute  Metritis 293 

Chronic  Metritis  (Pyometra) 296 

Puerperal  Septicemia 298 

Eversion  of  the  Uterus  (Prolapse.     Inversion  of  the  Uterus) .      .  300 

Torsion  of  the  Cornua   Uteri 302 

Rupture  of  the  Uterus 303 

Tumors  of  the  Uterus 303 

Fibromata 303 

Myomata 304 

Hydrometra 304 

Dystocia 305 


CONTENTS  xiii 

CHAPTER  VII. 

DISEASES  OF  THE  VAGINA  AND  VULVA. 

Examination 309 

Congenital  Malformations 309 

Vaginitis  and  Vulvitis 309 

Prolapse  of  the  Vagina ,  311 

Rupture  of  the  Vagina 313 

Tumors  of  the  Vulva  and  Vagina 313 

Fibromata 313 

Papillomata 314 

Sarcomata        314 

Venereal  Granulomata 314 

CHAPTER  VIII. 

DISEASES  OF  THE  MAMMARY  GLANDS. 

Examination 315 

Wounds  and  Injuries  of  the  Mammary  Glands 315 

Congestion  of  the  Mammary  Glands .316 

Mammitis  (Mastitis) 316 

Tumors  of  the  Mammary  Glands 317 

Benign  Tumors 317 

Fibromata 317 

Lipoma 318 

Malignant  Tumors 318 

Carcinomata 318 

Sarcomata                   318 


PART  V. 

DISEASES  OF  THE  BLOOD  AND  BLOOD  . 
PRODUCING  ORGANS. 

CHAPTER  I. 

Anemia 319 

Leukemia 322 

Infectious  Leukemia  of  Chickens 325 

Pseudoleukemia  (Hodgkin's  Disease) 327 

Hemophilia 328 

Scurvy  (Scorbutus) 328 


xiv  CONTENTS 

Animal  Parasites  in  the  Blood.     (Filariaj.     Metastrongulinse)      .  330 

Dirofilaria  Immitis  (Filaria  Ininiitis) 330 

Hematozoon  Lewlsi 332 

Hsemostrongylus  Vasorum 332 

Spiroptera  Sanguinolenta 333 

CHAPTER  II. 
DISEASES  OF  THE  THYROID  GLANDS. 

Examination  and  General  Consideration 334 

Congestion  of  the  Thyroid  Glands 334 

Acute  Thyroiditis 335 

Goiter  (Struma.     Bronchocele) 336 

Parenchymatous  Goiter .  336 

Cystic  Goiter 339 

Fibrous  Goiter 340 

Vascular  Goiter 341 

Malignant  Goiter 342 

Exophthalmic  Goiter  (Basedow's  Disease.     Graves's  Disease)  343 


PART  VI. 

> 

DISEASES  OF  METABOLISM. 

CHAPTER  I. 

DISEASES  OF  METABOLISM. 

Diabetes 347 

Diabetes  Insipidus 347 

Diabetes  Mellitus 350 

Obesity 352 

Gout  (Podagra.     Arthritis  Urica) 354 

Feather  Eating  (Feather  Pulling  in  Birds)    .      .   ' 357 

CHAPTER  II. 

DISEASES  OF  METABOLISM  AFFECTING  PRIMARILY  THE  BONES. 

Rachitis   (Rickets) 359 

Osteomalacia  (Brittleness  of  Bones)   .  362 


CONTENTS  xv 

PART  VII. 
DISEASES  OF  THE  ORGANS  OF  LOCOMOTION. 

CHAPTER  I. 

Articular  Rheumatism  (Polyarthritis  Rheumatica)      ....  363 

Muscular  Rheumatism 365 

Fracture  of  Bones •„....  368 

Cranial  Bones 368 

Fracture  of  the  Inferior  Maxilla 369 

Fracture  of  the  Vertebrae 370 

Fracture  of  the  Ribs 371 

Fracture  of  the  Scapula 371 

Fracture  of  the  Humerus 372 

Fracture  of  the  Radius  and  Ulna      .     • 372 

Fracture  of  the  Metacarpal  and  Phalangeal  Bones      .      .      .  373 

Fracture  of  the  Pelvis 373 

Fracture  of  the  Femur 374 

Fracture  of  the  Patella 375 

Fracture  of  the  Tibia  and  Fibula 375 

CHAPTER  II. 

DISEASES  OF  THE  ARTICULATIONS. 

Wounds  of  the  Articulations 376 

Sprains  and  Injuries  to  the  Articulations 377 

Dislocation  of  the  Articulations  (Luxation) 378 

Temporomaxillary 378 

Vertebral .-     .      .  379 

Scapulohumeral 379 

Humero-radio-ulnar 379 

Radio-ulnar-carpal 380 

Phalangeal 381 

Coxofemoral 381 

Patellar 382 

Tibiotarsal • 383 

Caudal  Vertebra; 383 

Inflammation    of   the    Synovial    Membrane    and    Articulations. 

(Synovitis.     Arthritis) 383 


xvi  CONTENTS 

PART'VIII. 
DISEASES  OF  THE  URINARY  SYSTEM. 

CHAPTER  I. 

DISEASES  OF  THE  KIDNEYS. 

Examination 385 

Congestion  of  the  Kidneys  (Hyperemia . )      .    - 387 

Acute  Hyperemia 387 

Passive  Hyperemia 388 

Inflammation  of  the  Kidneys  (Nephritis) 388 

Acute  Nephritis 388 

Chronic  Nephritis 392 

Purulent  Nephritis  (Kidney  Abscess) 396 

Inflammation  of  the  Renal  Pelvis  (Pyelitis) . 398 

Uremia 400 

Calculi  in  the  Kidney  (Nephrolithiasis) 402 

Dropsy  of  the  Kidney  (Hydronephrosis.     Cystic  Kidney) .      .      .  405 

Amyloid  Kidney 407 

Tumors  in  the  Kidney 407 

Animal  Parasites  in  the  Kidney 407 

Dioctophyme  Renale  (Eustrongylus  Gigas) 407 

Other  Parasites  in  the  Kidney .      .  409 

CHAPTER  II. 

DISEASES  OF  THE  BLADDER. 

Examination 410 

Wounds  of  the  Bladder 412 

Rupture  of  the  Bladder 412 

Retention  of  Urine  in  the  Bladder  (Retcntio  Urinse  Vcsicalis)      .  414 

Incontinence  of  Urine 416 

Catarrh  of  the  Bladder  (Cystitis.     Urocystitis) 416 

Torsion  of  the  Bladder 420 

Calculi  in  the  Bladder 420 

Tumors  of  the  Bladder 423 

Parasites  in  the  Bladder                                                                 .      .  423 


CONTENTS  xvii 


CHAPTER  III. 

DISEASES  OF  THE  URETHRA. 

Examination 425 

Congenital  Malformations  (Occlusion  of  the  Urethra) ....  425 

Wounds  of  the  Urethra 426 

Stricture  of  the  Urethra 426 

Calculi  in  the  Urethra 427 

Inflammation  of  the  Urethra  (Urethritis) 420 


PART  IX. 
DISEASES  OF  THE  NERVOUS  SYSTEM. 

CHAPTER  I. 

DISEASES  OF  THE  BRAIN. 

General  Considerations 431 

Examination 432 

Psychic  Disturbances 433 

Sensibility 433 

Hyperemia  of  the  Brain  (Congestion  of  the  Brain) 435 

Anemia  of  the  Brain  (Cerebral  Anemia) 437 

Meningo-eqcephalitis 438 

Cerebral  Hemorrhage  (Apoplexy) 440 

Tumors  of  the  Brain 441 

CHAPTER  II. 

DISEASES  OF  THE  SPINAL  CORD. 

General  Considerations 443 

Examination 443 

Meningomyelitis 443 

Concussion  of  the  Spinal  Cord  (Injuries  of  the  Spinal  Cord)   .      .  445 

Compression  of  the  Spinal  Cord 448 


xviii  CONTENTS 

CHAPTER  III. 

DISEASES  OF  THE  PERIPHERAL  NERVOUS  SYSTEM. 

Injuries  of  the  Peripheral  Nerves 450 

Pressure  upon  the  Peripheral  Nerves  (Compression)     ....  450 

Paralysis  of  the  Peripheral  Nerves 450 

Facial  Nerve 450 

Trigeminal  Nerve 452 

Auditory  Nerve 453 

Radial  Nerve 454 

Brachial  Plexus 455 

Sciatic  Nerve 456 

CHAPTER  IV. 

FUNCTIONAL  NERVOUS  DISEASES. 

Vertigo  (Megrim) 455 

Epilepsy 456 

Reflex  or  Secondary  Epilepsy 459 

Catalepsy 460 

Chorea 461 

Eclampsia 462 


PART  X. 
DISEASES  OF  THE  SKIN. 

CHAPTER  I. 

NON-PARASITIC  SKIN  DISEASES. 

Examination 463 

Dandruff .464 

Alopecia 465 

Dermatitis 466 

Acne 468 

Eczema 469 


CONTENTS  xix 

CHAPTER  II. 

PARASITIC  SKIN  DISEASES. 

Fleas 472 

Lice 473 

Scabies  (Mange.     Red  Mange.     Itch)     ...     T     ....  475 

Sarcoptes  Mite 476 

Demodex  Mite 480 

Dermatomycosis  (Vegetable  Parasitic  Disease  of  the  Skin)      .      .  482 

Herpes  Tonsurans  (Ringworm.     Red  Itch) 482 

Favus  (Honeycomb  Ringworm.     Comb  Disease.     White  Comb)  484 


PART  XL 
DISEASES  OF  THE  EAR. 

Examination 487 

Wounds  of  the  Ear ' 487 

Ulceration  of  the  Concha 488 

Hematoma 489 

Otitis  Externa  (Otorrhea) 490 

Otitis  Media  and  Interna .  493 

Tumors  (Neoplasms  of  the  Ear) 493 

Papillomata 493 

Sebaceous  Tumors  or  Cysts 494 

Parasites  in  the  Ear 494 

Deafness 495 

Ear  Fistula    .  495 


PART  XII. 
DISEASES  OF  THE  EYE. 

CHAPTER  I. 

DISEASES  OF  THE  EYELIDS. 

Examination 497 

Wounds  of  the  Eyelids 497 

Inflammation  of  the  Eyelids  (Blepharitis) 498 


xx  CONTENTS 

Malposition  of  the  Eyelids 499 

Entropion 499 

Ectropion 500 

Ptosis  (Blepharoptosis) 501 

Paralysis  of  the  Orbicularis  Nerve 502 

Spasm  of  the  Orbicularis  Nerve  (Blepharospasm)  .  503 

Trichiasis 503 

Districhiasis 504 

Adhesions  of  the  Eyelids 504 

Ankyloblepharon 505 

Symblepharon 505 

Lagophthalmos 506 

Tumors  of  the  Eyelids 506 

Papillomata  (Warts) 506 

Chalazion  (Meibomian  Cyst) 507 

Pilosebaceous  Cysts 507 

Lipoina  and  Sebaceous  Tumors  in  Birds 508 

Enlargement  of  the  Glands  of  Moll        508 

Granulomas 508 

Malignant  Neoplasms 508 

CHAPTER  II. 

DlSKASES   OF   THE    CONJUNCTIVA. 

Examination 510 

Conjunctivitis 510 

Catarrhal  Conjunctivitis 511 

Purulent  Conjunctivitis  (Blennorrhea) 512 

Parenchymatous  Conjunctivitis  (Erysipelatious  Conjunctivi- 
tis)        514 

Croupous  Conjunctivitis 516 

Follicular  Conjunctivitis 517 

Exanthematous  Conjunctivitis 518 

Pterygium • 519 

Traumatic  Lesions  of  the  Conjunctiva 519 

Foreign  Bodies  in  the  Conjunctiva 519 

Wounds  of  the  Conjunctiva 520 

Corrosions  and  Burns  of  the  Conjunctiva 521 

Ulceration  of  the  Conjunctiva 521 

Tumors  and  Growths  on  the  Conjunctiva 522 

Inflammation  of  the  Membrana  Nictitans 522 

Wounds  of  the  Membrana  Nictitans 523 

Tumors  of  the  Membrana  Nictitans  .  523 


CONTENTS 


CHAPTER  III. 

DISEASES  OF  THE  LACRIMAL  APPARATUS. 

Examination        524 

Lamination  (Epiphora) 524 

Dacryocystitis 525 

CHAPTER  IV. 

DISEASES  OF  THE  CORNEA. 

Examination 526 

Keratitis '....-.  526 

Non-suppurative  Keratitis 527 

Superficial  Keratitis 527 

Vascular  Keratitis  (Pannus) 528 

Keratitis  Pigmentosa  (PigmentaryjKeratitis; .      .      .      .  529 

Keratitis  Punctata  Superficialis  (Facetted  Keratitis)       .  529 

Parenchymatous  Keratitis 530 

Keratitis  Punctata  Profunda 532 

Suppurative  Keratitis 532 

Ulceration  of  the  Cornea 532 

Abscess  of  the  Cornea 534 

Keratitis  Xeuroparalytica 535 

Keratitis  from  Lagophthalmus 535 

Foreign  Bodies  and  Wounds  of  the  Cornea 535 

Opacities  of  the  Cornea 536 

Ectasia  of  the  Cornea 537 

Inflammatory  Ectasia 537 

Staphyloma 537 

Keratectasia 537 

Non-inflammatory  Ectasia 538 

Keratoconus 538 

Keratoglobus 538 

Tumors  of  the  Cornea 538 

CHAPTER  V. 
DISEASES  OF  THE  IRIS  AND  CILIARY  BODY. 

Congenital  Defects  of  the  Iris 539 

Mydriasis 540 

Myosis 540 

Iritis  and  Cyclitis  (Iridocyclitis) 540 

Cysts  and  Tumors  of  the  Iris  .  541 


xxn  CONTENTS 


CHAPTER  VI. 

DISEASES  OF  THE  LENS. 

Examination 542 

Cataract 542 

Luxation  of  the  Lens  544 


CHAPTER  VII. 

DISEASES  OF  THE  RETINA  AND  CHOROID    .      .      .  545 

CHAPTER  VIII. 

DISEASES  OF  THE  OPTIC  NERVE. 

Papillitis 546 

Retrobulbar  Neuritis 546 

Atrophy  of  the  Optic  Nerve 547 

Amblyopia 547 

Amaurosis  547 


CHAPTER  IX. 
DISEASES  OF  THE  GLOBE  AND  ORBIT. 

Panophthalmitis 548 

Glaucoma 549 

Hydropthalmus 550 

Exophthalmus 550 

Luxation  of  the  Eyeball 550 

Enophthalmus 551 

Strabismus • 552 

Nystagmus 552 

Parasites  of  the  Eye 553 

Fracture  of  the  Orbit 553 

Inflammation  of  the  Orbit 553 

Tumors  of  the  Orbit  .      .      .  553 


CONTENTS  xxiii 


PART  XIII. 
HERNIA. 

General  Remarks 555 

Umbilical  Hernia 557 

Ventral  Hernia 558 

Inguinal  Hernia 560 

Inguinal  Hernia  in  the  Female 560 

Inguinal  and  Scrotal  Hernia  in  the  Male 561 

Femoral  Hernia 562 

Diaphragmatic  Hernia 563 

Perineal  Hernia  .  563 


PART  XIV. 
INFECTIOUS  DISEASES. 

CHAPTER  I. 
ACUTE  GENERAL  INFECTIOUS  DISEASES. 

Distemper  of  Dogs 565 

Distemper  of  Cats 577 

Typhus  of  Dogs  (Canine  Typhus.  Hemorrhagic  Gastro-enteritis. 

Dog  Plague.  Black  Tongue) 579 

Purpura  Hemorrhagica  of  Dogs 583 

Fowl  Cholera  (Cholera  Gallinarum.  Pasteurellosis  Avium.  Fowl 

Typhoid) 584 

Fowl  Pest  (Fowl  Plague.  Pestus  Avium) 589 

CHAPTER  II. 
ACUTE  INFECTIOUS  DISEASES  WITH  LOCALIZATION  IN  CERTAIN  ORGANS. 

Epitheliosis  Infectiosa  Avium  (Contagious  Epithelioma.     Chicken- 
pox.     Diphtheria.     Roup.     Canker) 593 

Anthrax 599 

Foot-and-mouth  Disease  (Aphthae  Epizootics:) 600 

Hemorrhagic  Septicemia  of  Cats  (Infectious  Gastro-enteritis) .      .     600 


xxiv  CONTENTS 


CHAPTER  III. 

INFECTIOUS  DISEASES  WITH  SPECIAL  INVOLVEMENT  OF  THE  NERVOUS 

SYSTEM. 

Rabies  (Hydrophobia.     Lyssa) 603 

Infectious  Bulbar  Paralysis  (Pseudorabies) 611 

Tetanus  (Lockjaw) 613 


CHAPTER  IV. 

CHRONIC  INFECTIOUS  DISEASES. 

Tuberculosis  of  Birds  (Tuberculosis  Avium.     Avian  Tuberculosis)  616 

Tuberculosis  of  Dogs  and  Cats 620 

Glanders 622 

Pseudo-act  inomycosis  of  Dogs  (Streptotrichosis  Canum.  Actiuo-  . 

myces  Canis) 623 


CHAPTER  V. 

INFECTIOUS  DISEASES  PRODUCED  BY  PROTOZOA. 

Spirochaetosis    of    Fowls    (Spirochsetosis    Avium.     Spirillosis    of 

Chickens) 625 

Enterohepatitis  (Blackhead) 627 

Infectious  Diarrhea  of  Chicks  (White  Diarrhea) 629 

Piroplasmosis  of  the  Dog  (Infectious  Jaundice.     Biliary  Fever. 

Malignant  Jaundice) 633 

Table  of  Equivalents  in  Weights  and  Measures 637 


DISEASES  OF  THE  SMALL  DOMESTIC 
ANIMALS. 


PART  I. 
DISEASES  OF  THE  RESPIRATORY  SYSTEM. 


CHAPTER  I. 
DISEASES  OF  THE  NASAL  PASSAGES. 

Examination.— The  nasal  passages  are  very  small  and  do 
not  admit  of  a  free  examination.  In  some  breeds  of  dogs 
(English  bull)  there  is  an  obstruction  of  the  nasal  passages 
which  during  inspiration  produces  a  peculiar  snoring  sound. 
This  should  not  be  mistaken  for  an  abnormal  condition.  In 
other  breeds  (Collie)  where  the  nasal  passages  are  longer 
and  less  tortuous  respiration  produces  no  sound.  Dogs 
breathe  freely  through  the  mouth.  In  the  cat  the  nasal 
passages  are  very  small  and  short  and  can  only  be  examined 
at  their  openings. 

The  examination  of  the  nasal  passages  should  be  made  as 
follows:  Good  light  such  as  ordinary  daylight  or  strong 
artificial  light  is  necessary.  A  mirror  to  reflect  light  into 
the  nasal  openings  is  of  little  value  as  the  passages  are  so 
small  that  the  light  will  be  reflected  only  a  short  distance. 
A  very  small  nasal  dilator  will  be  found  useful  in  some  of 
the  larger  breeds.  A  small  flexible  probe  with  a  pledget  of 
cotton  securely  wrapped  around  one  end,  large  enough  to 
occlude  the  nostril  when  inserted  rather  high  up,  will  at  once 
2 


18  DISEASES  OF  THE  NASAL  PASSAGES 

induce  sneezing  and  the  character  of  the  secretions  from  the 
opposite  nostril  can  be  more  easily  determined.  The  probe 
is  then  removed  and  inserted  in  the  other  nostril  for  a  similar 
examination.  The  nose  in  health  is  moist  and  cool  with  a 
very  thin,  slight  mucous  discharge.  The  mucous  membrane 
is  variable  in  color;  in  most  breeds  dark,  in  others  light  with 
dark  spots,  and  in  a  few  breeds  pink. 

Abnormal  conditions  to  be  noted  are  the  following: 

Turn  or*.— Small  papillomas  on  the  skin  and  mucous 
membrane  at  the  entrance  to  the  nasal  openings  are  fre- 
quently seen.  Epitheliomas  extending  from  the  lips  to  form 
a  diffuse  enlargement  which  may  partially  or  completely 
obstruct  the  nasal  openings.  Polypoid  enlargements  on  the 
mucous  membrane  of  the  nasal  passages  are  often  noted  and 
can  be  accurately  determined  by  using  a  small,  fine  wire 
snare  to  pull  them  toward  the  nasal  opening. 

Foreign  Bodies. — Frequently  in  hunting  dogs  small  pieces 
of  straw,  twigs  and  other  foreign  material  will  be  found  rather 
high  up  in  the  passages.  These  injure  the  mucous  membrane 
and  often  become  deeply  imbedded  in  it  and  the  underlying 
tissues. 

Parasites.— The  Pentastoma  rhinaria  (Linguatula  rhinaria) 
is  occasionally  found  in  the  nasal  passages  and  when  suspected 
the  nasal  discharge  should  be  examined  microscopically  to 
reveal  the  presence  of  the  eggs  of  the  parasite. 

Infectious.— Distemper  infection  frequently  takes  place  in 
the  nasal  passages  and  produces  both  local  and  general 
symptoms.  Staphylococcus  infection  from  wounds  in  the 
mucous  membrane,  or  as  secondary  infection  following  dis- 
temper, is  of  common  occurrence.  In  these  conditions  the 
nose  is  usually  dry  and  hot,  showing  numerous  fissures  on 
the  mucous  membrane  and  nose  at  the  borders  of  the  nasal 
openings. 

Hemorrhage.— This  occurs  often  from  injuries,  as  blows 
over  the  nasal  bones,  fractures  of  the  nasal  bones;  from 
punctured  wounds  through  the  bones  and  from  injury  to  the 
turbinated  bones. 

Malformations.— Some  diseases  (rachitis)  produce  a  de- 
formity of  the  nasal  bones  interfering  with  the  free  passage 


ACUTE  NASAL  CATARRH  19 

of  air  through  the  nostrils  and  producing  marked  enlarge- 
ment of  the  nose. 

Discharge.— In  acute  and  chronic  nasal  catarrh  (coryza, 
rhinitis)  the  mucous  and  serous  discharge  from  the  nasal 
passages  is  greatly  increased.  The  general  condition  is  but 
little  disturbed. 

ACUTE  NASAL  CATARRH. 

Coryza.     Rhinitis. 

Definition. —Acute  inflammatory  condition  of  the  nasal 
mucous  membrane  producing  a  serous  or  mucous  discharge. 
Etiology.  —  (a)  Inhalations  of  dust  or  other  foreign  material. 
(6)  Inhalations  of  irritating  gases  or  chemicals. 

(c)  Exposure  to  cold  (cold  draughts  of  air). 

(d)  Ordinary    infection    (staphylococcus,    etc.);    specific 
infections  (distemper,  etc.). 

(e)  Linguatula  rhinaria  (early  stages  of  invasion) . 
During  the  first  stages  there  is  hyperemia  and  dryness  of 

the  nasal  mucosa,  which  is  soon  followed  by  a  discharge  that 
is  serous,  seromucous,  or  mucopurulent.  This  discharge 
often  causes  excoriation  of  the  tissues  with  which  it  comes  in 
contact.  In  non-pigmented  membranes  the  congestion  is 
more  prominent. 

The  discharge  when  examined  with  the  microscope  shows 
epithelial  cells,  leukocytes,  bacteria  and  sometimes  the  eggs 
of  the  parasite,  Linguatula  rhinaria. 

Symptoms.— Sneezing  and  the  presence  of  a  thin,  serous 
discharge  in  the  early  stages,  which  later  is  mixed  with  mucus, 
becomes  dry  and  adheres  around  the  nasal  openings.  The 
nose  is  rubbed  against  objects  and  wiped  with  the  paws. 
Excoriations  appear  around  the  margins  of  nasal  openings. 

Diagnosis.— The  presence  of  the  above  symptoms  and  the 
absence  of  any  general  disturbance  characterize  simple 
rhinitis. 

Prognosis.  Eavorable.— Recovery  usually  takes  place  in 
about  one  to  two  weeks. 

Treatment.—  Hygienic.—  The  animal  should  be  kept  warm 
and  protected  from  draughts  of  cold  air. 


20  DISEASES  OF  THE  NASAL  PASSAGES 

Medical.— Spray  the  nasal  passages  with  a  warm  boric 
acid  (2  per  cent.)  or  sodium  bicarbonate  (2  per  cent.)  solution. 
Remove  the  dry  discharge  from  the  edge  of  the  nasal  openings. 
Apply  vaselin  or  zinc  oxid  ointment  to  those  parts  as  protec- 
tive agents. 

EMPYEMA  OF  THE  INFRAOEBITAL  FOSS/E  OF  BIRDS. 

Definition.— A  collection  of  pus  in  the  infraorbital  fossae 
which  causes  a  distention  of  one  or  both  of  them. 

Etiology.— This  condition  usually  occurs  during  the  course 
of  infectious  nasal  catarrh,  diphtheria  or  parasites  (monos- 
toma).  The  mucous  membrane  becomes  infected  and  the 
purulent  material  collects  in  the  fossse  greatly  distending 
them. 

Symptoms.— A  warm  painful  swelling  is  noticed  in  the  infra- 
orbital  region,  which  may  affect  one  or  both  sides.  The 
enlargement,  which  is  quite  firm,  protrudes  over  and  closes 
the  eye. 

Prognosis.— Depends  upon  the  primary  cause.  When  the 
affection  is  confined  to  the  fossae  the  prognosis  is  favorable. 

Treatment.— Surgical.—  An  incision  should  be  made  over 
the  enlargement  and  the  accumulated  material  which  is 
quite  hard  and  firm  removed  with  a  curette.  The  cavity 
should  be  washed  with  antiseptics. 

INFECTIOUS  NASAL  CATARRH  OF  RABBITS. 

Rabbit  Plague.     Rabbit  Influenza.  Rabbit  Distemper. 

Definition.— An  infectious  disease  involving  the  mucous 
membrane  of  the  nasal  passages,  which  later  produces  general 
infection. 

Etiology.— The  exciting  cause  is  a  small,  slender,  immobile 
bacillus,  similar  in  size  to  the  bacillus  of  cholera  in  birds.  It 
does  not  form  spores  and  is  Gram-negative.  This  organism 
is  also  pathogenic  to  guinea-pigs  and  mice,  but  rabbits  are 
most  susceptible.  Infection  takes  place  by  inhalation  during 
cohabitation  with  affected  animals,  or  by  being  taken  in  with 


INFECTIOUS  NASAL  CATARRH  OF  RABBITS        21 

the  food.  The  organism  produces  a  severe  inflammation  of 
the  mucosa  of  the  nasal  passages  and  sinuses,  and  later  enters 
the  circulation  producing  general  infection,  causing  elevation 
of  temperature  and  in  most  cases  an  inflammation  of  the 
serous  membranes.  The  infection  is  often  carried  directly  to 
the  trachea,  bronchial  tubes  and  lungs,  where  it  produces  an 
acute  inflammatory  condition. 

Necropsy.— The  nasal,  oral  and  pharyngeal  mucous  mem- 
branes .are  intensively  congested,  swollen  and  covered  with  a 
purulent  exudate.  In  the  lungs  are  often  found  evidences 
of  a  bronchopneumonia.  The  thoracic  cavity  may  contain 
a  serous  or  purulent  exudate  with  fibrinous  deposits  on  the 
pleura.  The  peritoneum  will  also  show  inflammation  with 
some  exudate  in  the  abdominal  cavity.  The  bacilli  can  be 
found  in  large  numbers  in  the  exudate  and  in  affected  organs. 

Symptoms.— The  incubation  period  is  from  four  to  six 
days.  The  first  symptoms  noticed  are  depression,  a  copious 
discharge  of  serous  secretion  from  both  nasal  openings  and 
severe  sneezing.  The  temperature  is  usually  from  104°-106° 
F.  and  there  is  complete  loss  of  appetite.  This  discharge 
soon  becomes  thick  and  tenacious,  adhering  around  the  nasal 
openings  and  on  the  hair  of  the  chest  and  limbs,  the  animal 
frequently  rubbing  its  nose  with  its  paws  to  relieve  the  intense 
irritation.  With  the  extension  of  the  inflammation  to  the 
larynx  and  bronchi,  dyspnea  and  coughing  result.  Exhaus- 
tion is  soon  noticed  due  to  the  general  infection  and  anorexia. 

Prognosis. — Very  unfavorable  in  acute  cases,  death  occur- 
ring in  three  to  five  days.  In  subacute  and  chronic  cases  in 
older  animals  the  course  is  fifteen  to  thirty  days.  Complete 
recovery,  however,  is  rare;  chronic  nasal  catarrh  is  a  common 
sequel. 

Diagnosis.— The  rapid  development,  high  temperature, 
absence  of  coccidia  (see  rhinitis  coccidiosa),  the  acute  inflam- 
mation of  the  serous  membranes  and  the  finding  of  the  specific 
bacillus  in  the  discharges  confirm  the  diagnosis. 

Treatment.— M  edicaL—  The  nasal  passages  should  be 
sprayed  with  antiseptic  solutions  (boric  acid  2  per  cent,  or 
sodium  bicarbonate  2  per  cent.),  the  accumulated  crusts 
removed  with  warm  water  and  a  protective  dressing  of  zinc 


22  DISEASES  OF  THE  NASAL  PASSAGES 

oxid  ointment  or  vaselin  applied.  The  use  of  internal  anti- 
septics (salol  0.12-0.2,  etc.)  is  indicated  to  combat  the 
general  infection.  Autogenic  vaccines  may  be  used. 

Prophylaxis.— All  material  soiled  by  the  nasal  discharges 
as  well  as  all  animals  that  die  should  be  burned  and  well 
covered  with  lime;  all  parts  of  the  hutch  and  the  runways 
thoroughly  disinfected,  and  a  quarantine  of  at  least  two 
weeks  imposed  upon  all  newly  acquired  animals. 

PARASITIC  NASAL  CATARRH  OF  RABBITS. 

Rhinitis  Coccidiosa. 

Definition.— An  inflammation  of  the  mucous  membrane 
of  the  nasal  passages  and  sinuses  due  to  an  infestation  with 
coccidia. 

Etiology . —This  condition  is  due  to  the  Coccidia  perforans 
or  the  Coccidia  oviformis,  which  gains  entrance  to  the  nasal 
passages  and  sinuses.  The  discharges  of  affected  animals 
are  infectious.  Damp  hutches  with  soiled  litter  and  filth 
in  them  favor  the  spread  of  the  disease.  Young  animals  are 
more  susceptible  than  those  fully  matured,  the  latter  usually 
contracting  the  disease  in  a  mild  form. 

Symptoms.— The  clinical  symptoms  are  similar  to  those  of 
infectious  nasal  catarrh.  The  nasal  discharge  is  present, 
being  serous  at  first,  later  becoming  thick  and  tenacious. 
After  two  or  three  days  the  animals  become  depressed,  fre- 
quently gnashing  the  teeth  and  rubbing  the  nose.  The  tem- 
perature, however,  is  subnormal.  In  some  cases  the  mucous 
membranes  of  the  mouth  and  the  conjunctiva  exhibit 
catarrhal  symptoms.  In  cases  where  the  coccidia  pass  into 
the  middle  ear,  the  semicircular  canals  become  involved 
causing  the  head  to  be  carried  to  one  side,  staggering  gait, 
and(  in  some  cases  rolling  over  and  over.  Spasms  of  the 
muscles  occur  followed  by  paralysis.  Paralysis,  however, 
is  a  symptom  of  many  irritating  conditions  in  rabbits  which 
in  other  animals  ordinarily  cause  excitement.  Later  a  pro- 
fuse diarrhea  is  noticed  followed  rapidly  by  exhaustion  and 
death. 


CHRONIC  NASAL  CATARRH  23 

Diagnosis.— Microscopic  examination  of  the  nasal  dis- 
charges reveals  the  presence  of  the  coccidia.  In  otodectes 
cynotis  mange,  catarrhal  symptoms  of  the  mucous  mem- 
brane are  absent. 

Prognosis. —Unfavorable. 

Treatment.— The  nasal  passages,  eyes  and  mouth  are 
cleansed  with  antiseptic  solutions  and  astringents  (boric  acid 
2  per  cent.,  zinc  sulphate  1  per  cent.,  copper  sulphate  1  per 
cent.,  creolin  2  per  cent.).  Small  doses  of  sulphur  (0.1-0.2) 
may  be  given  every  four  to  six  hours  to  produce  antiseptic 
and  laxative  action. 

Prevention.— (See  Infectious  Nasal  Catarrh  of  Rabbits.) 

CHRONIC  NASAL  CATARRH. 

Chronic  Coryza.     Chronic  Rhinitis. 

Definition.— A  chronic  inflammatory  condition  of  the 
mucous  membrane  of  the  nasal  passages  with  a  mucopurulent 
discharge. 

Etiology.— Usually  follows  repeated  attacks  of  acute  nasal 
catarrh;  ordinary  infection;  tumors. 

Pathology.  —  (a)  In  the  productive  or  hypertrophic  form 
there  is  a  generalized  infiltration  of  the  mucosa,  particularly 
that  covering  the  lower  portion  of  the  turbinated  bones, 
which  leads  to  a  more  or  less  extensive  thickening  of  the 
mucous  membrane.  The  mucous  glands  increase  in  size, 
there  is  a  thick,  viscid  secretion,  and  the  nasal  passages 
become  obstructed  by  enlargement  of  the  lower  part  of  the 
turbinated  bones.  The  atrophic  form  follows  the  course  of 
the  hypertrophic.  The  hyperplastic  tissue  atrophies,  the 
epithelium  of  the  mucosa  and  the  glands  is  destroyed,  and 
there  is  a  collection  of  a  yellowish,  purulent  material  on  the 
surface  of  the  mucous  membrane.  (6)  The  discharge  from 
the  nasal  passages  contains  bacteria,  leukocytes,  red  cor- 
puscles and  epithelial  cells. 

Symptoms.— A  purulent  discharge  varying  in  quantity 
from  both  nasal  passages.  This  discharge  in  severe  cases  is 
streaked  with  blood  and  has  a  very  offensive  odor;  it  causes 


24  DISEASES  OF  THE  NASAL  PASSAGES 

excoriations  on  the  mucous  membrane  and  skin  at  the  nasal 
openings,  where  it  drys  and  forms  hard  crusts.  There  are 
frequent  paroxysms  of  sneezing.  In  cases  where  the  nasal 
passages  are  occluded  the  animal  breathes  through  its  mouth. 
In  some  cases  where  infection  is  severe  general  symptoms  of 
loss  of  appetite,  dulness  and  emaciation  will  be  noted. 

Diagnosis. —The  presence  of  the  nasal  discharge,  the  chronic 
course  and  the  mild  general  symptoms  in  severe  cases. 

Prognosis.— Not  so  favorable  as  acute  nasal  catarrh.  It 
requires  several  weeks  for  a  complete  disappearance  of  the 
symptoms. 

Treatment.  —  Hygienic.  —The  animal  should  be  kept  in  a 
warm  place  free  from  all  irritating  materials  which  might 
affect  the  nasal  mucous  membrane. 

Medical.—  The  nasal  passages  should  be  sprayed  daily  with 
creolin  (2  per  cent.),  boric  acid  (2  per  cent.),  or  sodium  bicar- 
bonate (2  per  cent.)  solution;  the  dried  crusts  may  be  removed 
with  warm  water,  and  zinc  oxid  ointment  applied  to  the 
membranes  and  skin  at  the  nasal  openings. 

Sera-vaccine. — Cultures  may  be  grown  from  the  nasal  dis- 
charge, and  a  standardized  autogenic  vaccine  made.  Two 
c.c.  of  this  vaccine  are  injected  subcutaneously  every  five  to 
seven  days  until  the  purulent  discharge  ceases. 


EPISTAXIS. 

Definition.— Hemorrhages  from  the  nasal  passages. 

Etiology .  — (a)  Injuries  to  the  nasal  mucous  membrane 
from  foreign  bodies  (straws,  twigs,  etc.);  probing;  injuries 
to  the  turbinated  bones  due  to  fractures  or  trephining  the 
sinuses. 

(6)  Carbolic  acid  poisoning  causing  necrosis  of  the  mem- 
brane extending  into  the  nasal  passages  which  opens  the 
vessels. 

(c)  Specific  and  ordinary  infections  during  the  course  of 
distemper  and  chronic  nasal  catarrh. 

(d)  Parasitic  invasion  (Linguatula  rhinaria).  Hemorrhage 
occurs  during  the  course  of  the  following  disease  conditions : 


PARASITES  OF  THE  NASAL  PASSAGES  25 

Hemophilia,  plethora,  leukemia,  parasitic  anemia  and 
catarrhal  pneumonia. 

Symptoms.— A  unilateral  or  bilateral  discharge  of  blood 
from  the  nasal  passages.  When  primary  the  blood  is  of  a 
bright  red  color  and  flows  away  a  few  drops  at  a  time  or  the 
flow  may  be  copious,  and  sometimes  sufficient  to  produce 
general  symptoms.  When  secondary  to  chronic  nasal 
catarrh  or  distemper  it  is  mixed  with  the  secretions. 

As  small  animals  lick  the  nose  the  amount  of  hemorrhage 
is  not  easily  determined. 

Prognosis.— The  prognosis  depends  on  the  character  and 
amount  of  the  hemorrhage.  Most  cases  terminate  favorably. 

Treatment.— Medical.— In  mild  cases  when  treatment  is 
necessary  use  injections  of  cold  water  (ice-water)  or  alum 
solution  (3  per  cent.)  into  the  nasal  passages.  In  severe 
cases  when  hemorrhage  is  copious  and  persistent  use  injec- 
tions of  adrenalin  chlorid  (1-1000)  solution.  Give  internally 
iron  and  quinin  citrate  (0.2-0.35)  three  times  daily;  or  adre- 
nalin chlorid  (1-1000)  ten  to  twenty  drops,  twice  daily. 

Surgical.—  When  the  hemorrhage  is  continuous  and  cannot 
be  stopped  by  medical  treatment,  it  will  be  necessary  to  use 
a  tampon  made  of  gauze  and  saturated  in  an  alum  (3  per 
cent.)  or  tannic  acid  (3  per  cent.)  solution.  They  should  be 
inserted  with  a  small  flexible  probe  firmly  and  carefully  as 
far  up  the  nasal  passages  as  possible.  In  some  cases  it  will 
be  necessary  to  use  the  same  kind  of  a  tampon  inserted  in  the 
posterior  part  of  the  nasal  passage.  This  is  best  accom- 
plished by  use  of  the  mouth  speculum  and  a  flexible  probe 
bent  in  the  shape  of  a  hook.  When  a  tampon  is  inserted  a 
free  end  should  be  exposed  to  facilitate  removal.  As  small 
animals  breathe  freely  through  the  mouth  tampons  may  be 
inserted  in  both  nasal  passages. 

PARASITES  OF  THE  NASAL  PASSAGES. 

Definition.— Infestation  of  the  nasal  passages  and  chambers 
by  the  Linguatula  rhinaria. 

Etiology.—  History.—  The  infestation  of  the  dog  with  this 
parasite  is  rather  rare  in  the  United  States.  Only  a  few  cases 


26      DISEASES  OF  THE  NASAL  PASSAGES 

have  been  recorded,  but  in  other  countries  (France,  Germany) 
they  are  frequently  found.  The  Linguatula  rhinaria  are 
white,  the  body  lanceolated,  elongated,  vermiform  and  flat- 
tened above  and  below,  the  ventral  surface  nearly  plane,  the 
dorsal  surface  rounded,  anterior  extremity  broad  and  rounded, 
posterior  extremity  attenuated.  The  thorax  is  short  and 
between  it  and  the  abdomen  there  is  no  distinct  boundary. 
The  integuments  show  about  ninety  rings  or  segments,  widest 
in  their  middle,  causing  the  margins  of  the  parasite  to  be 
distinctly  crenated.  The  hooks  are  sharp,  curved,  and  bi- 
articulated.  Each  hook  is  retractile  into  a  small  sheath  and 
is  moved  by  muscular  cords  arranged  in  different  direc- 
tions. The  mouth  is  rounded,  digestive  tube  rectilinear.  Size: 
Male,  18-20  mm.  long,  3  mm.  broad  in  front  and  0.5  mm. 
behind.  Female,  8-10  cm.  long,  8-10  mm.  broad  in  front 
and  2  mm.  behind.  The  eggs  are  ovoid,  90  mmm.  long  and 
70  mmm.  broad. 

The  life  cycle  of  the  Linguatula  rhinaria  is  as  follows: 
The  female  deposits  her  eggs  in  the  nasal  passages  of  the 
dog;  the  eggs  are  expelled  by  sneezing  and,  being  surrounded 
by  mucus,  they  adhere  to  grasses  or  whatever  they  happen 
to  come  in  contact  with.  The  grasses  are  eaten  by  any  of 
the  herbivorous  animals.  The  shells  of  the  eggs  are  dissolved 
by  the  gastric  juice  and  the  embryos  are  set  at  liberty  in  the 
intestinal  tract.  Each  embryo  is  provided  with  a  median 
stylet  and  two  curved  hooks  with  which  it  penetrates 
the  walls  of  the  intestines  and  reaches  the  peritoneum, 
mesenteric  glands,  liver  and  the  lungs  where  it  becomes 
encysted.  During  the  period  of  encystment  in  the  organs 
and  glands  the  embryo  undergoes  successive  changes  in  its 
development  and  becomes  a  larva  (Linguatula  denticulatum) . 
When  mature  the  larvae  migrate  by  means  of  their  hooks  and 
the  sharp  spiculse  on  their  skin.  Some  of  them  pass  into  the 
bronchi  and  trachea  reaching  the  nasal  passages  where  they 
develop  into  the  perfect  parasite.  Dogs  become  infested 
by  eating  the  viscera  of  animals  containing  the  larval  form 
which  passes  from  the  stomach  via  the  esophagus  to  the 
nasal  passages  where  it  develops. 


PARASITES  OF  THE  NASAL  PASSAGES  27 

Necropsy.— In  the  early  stages  of  the  invasion  of  the  Lin- 
guatula  rhinaria  they  attach  themselves  to  the  mucous 
membrane  of  the  nasal  cavities  producing  an  acute  inflam- 
mation. The  exudate  is  increased  in  quantity  and  later  is 
mixed  with  pus  covering  the  surface  of  the  mucous  membrane 
which  becomes  greatly  thickened  especially  around  the 
turbinated  bones  and  in  the  nasal  chambers.  In  the  later 
stages  necrosis  of  the  turbinated  bones  and  nasal  septum 
may  take  place. 

The  discharge  from  the  nasal  passages  often  contains  the 
parasites,  pus,  epithelial  cells  and  large  numbers  of  the  ovoid 
eggs. 

Symptoms.— In  the  early  stages  the  symptoms  are  par- 
oxysms of  sneezing;  obstruction  of  the  nasal  passages;  a 
discharge  which  is  at  first  serous,  later  becomes  mucopurulent, 
mixed  with  blood,  and  has  a  very  offensive  odor.  Accumula- 
tions of  the  dried  discharge  form  crusts  at  the  nasal  openings. 
In  animals  of  a  nervous  temperament  symptoms  of  excite- 
ment are  noted  from  reflex  irritation  of  the  nasal  passages. 
Severe  hemorrhage  is  seen  from  the  necrosis  opening  blood- 
vessels. ' 

Diagnosis.— The  presence  of  the  parasites  or  eggs  in  the 
nasal  discharge. 

Prognosis.— Depends  upon  the  number  of  parasites  and  the 
probability  of  becoming  reinfested. 

Treatment.— Medical.— Inhalations  of  small  amounts  of 
chloroform,  turpentine,  or  some  other  volatile  oils.  Spray 
the  passages  twice  daily  with  creolin  (2  per  cent.),  carbolic 
acid  (2  per  cent.),  or  boric  acid  (2  per  cent.)  solution.  Re- 
move the  crusts  from  around  the  nasal  openings  with  warm 
creolin  solution  and  apply  zinc  oxid  ointment  to  the  excori- 
ated membrane  and  skin.  Give  internally  tincture  mix  vomica 
(0.3-0.65)  daily;  iron  and  quinin  citrate  (0.2-0.4)  daily. 

Surgical.— Irrigation  of  the  nasal  passages  with  a  warm 
solution  of  creolin  (2  per  cent.).  This  can  be  done  by  using 
a  small,  soft  rubber  tube  inserted  as  high  up  in  the  nasal 
passages  as  possible.  Attach  a  funnel  to  the  other  end  and 
pour  the  solution  slowly  into  it  using  only  a  small  quantity 
of  the  fluid.  The  nasal  passages  can  also  be  irrigated  through 


28  DISEASES  OF  THE  NASAL  PASSAGES 

the  posterior  nares  by  the  use  of  a  hard  nozzle  bent  in  the 
form  of  a  curved  hook.  Depress  the  head  and  allow  the 
fluid  to  flow  out  through  the  nasal  passages. 

NEOPLASMS  OF  THE  NASAL  PASSAGES. 

Papillomata.— These  are  benign  tumors  having  a  frame- 
work of  fibrous  tissue  and  bloodvessels  covered  by  squamous 
epithelium.  The  surface  of  the  tumor  is  roughened  by  many 
elevations  and  proliferations.  Papillomata  are  most  com- 
monly located  around  the  margins  of  the  nasal  openings  and 
especially  at  the  juncture  of  the  skin  and  mucous  membrane. 
Sometimes  they  extend  a  short  distance  up  the  nasal  passages 
and  may  extend  to  the  skin  of  the  lips  and  the  nose.  They 
are  found  here  in  two  forms :  (a)  A  hard  form  which  presents 
smooth,  rounded  elevations  on  the  skin.  (6)  A  soft  form, 
which  is  pedunculated,  has  an  irregular,  broad  surface  and 
cauliflower-like  appearance.  The  soft  tumors  are  found  on 
the  mucous  membrane.  In  size  they  vary  from  that  of  a 
millet  seed  to  a  walnut.  There  may  be  a  large  number  or 
only  a  few  present. 

Treatment.— Surgical.—  They  are  removed  as  follows: 
The  animal  should  be  given  an  anesthetic  (morphin  subcu- 
taneously,  or  ether  inhalation).  Sterilize  curved  scissors, 
forceps  and  artery  forceps;  disinfect  the  surface  of  the  skin, 
mucous  membrane  and  tumors  with  boric  acid  solution 
(2  per  cent.).  Grasp  the  tumor  with  the  forceps  and  cut  off 
with  the  scissors,  and  if  the  hemorrhage  is  persistent  use  the 
artery  forceps.  Alum  (2  per  cent.)  or  silver  nitrate  solution 
(0.25-0.5)  may  afterward  be  applied.  The  after-treatment 
consists  in  washing  the  surface  where  the  tumors  are  removed 
with  antiseptic  solutions. 

Polypoid  Fibromata.— These  occur  as  enlargements  on  the 
mucous  membrane  of  the  nasal  passages  and  frequently 
interfere  with  breathing,  producing  complete  obstruction  of 
one  or  both  passages. 

Treatment. —These  are  best  removed  with  a  fine  wire  snare. 
Inject  astringent  solutions  (alum  2  per  cent.)  up  the  nasal 
passages  to  control  the  hemorrhage.  When  this  method  of 


NEOPLASMS  OF  THE  NASAL  PASSAGES  29 

removal  fails  it  is  best  to  trephine  the  superior  wall  of  the 
nasal  passages  and  extirpate  the  tumor  through  the  opening. 
After-treatment  consists  of  warm  antiseptic  solutions  injected 
daily  up  the  passages. 

Malignant  Tumors.— Occasionally  in  the  nasal  passages 
are  found  epitheliomas,  osteosarcomas,  and  sarcomas  which 
are  usually  secondary  to  primary  growths  having  their  origin 
in  the  buccal  mucosa,  maxillary  bones  or  lips  (epitheliomas) . 

Symptoms.— Malignant  growths  give  rise  to  distortions  of 
the  nasal  bones,  lips  and  often  result  in  necrosis  of  the  parts 
involved.  The  nasal  discharge  will  contain  necrotic  material 
and  blood  and  has  a  very  offensive  odor. 

Diagnosis. — To  make  an  accurate  diagnosis  some  of  the 
tumors  should  be  obtained  and  examined  microscopically. 

Prognosis.— The  prognosis  is  very  unfavorable. 

Treatment.— Owing  to  the  location  of  the  tumors,  their 
malignant  character  and  the  tissues  involved,  treatment  is 
not  to  be  attempted. 


CHAPTER  II. 
DISEASES  OF  THE  LARYNX. 

Examination.— (a)  With  the  mouth  speculum,  laryngo- 
scope and  good  light,  the  anterior  portion  of  the  larynx  and 
the  surrounding  tissues  can  be  readily  inspected  provided  the 
tongue  is  drawn  well  forward. 

(6)  By  examining  some  of  the  nasal  discharge  collected 
with  a  dressing  forceps  carrying  a  pledget  of  cotton,  its 
character  is  decided. 

(c)  By  palpation,  enlargements,  injuries  and  the  degree 
of  sensitiveness  may  be  determined. 

Laryngitis.— Two  forms  of  laryngitis  are  frequently 
observed  in  small  animals,  viz:  (a)  Acute,  and  (6)  chronic. 

Acute  Laryngitis.— Definition.— An  acute  catarrhal  inflam- 
mation of  the  mucous  membrane  of  the  larynx. 

Etiology.— (a)  Excessive  use  of  the  voice  (barking).  This 
is  often  seen  at  dog  shows;  in  hounds  after  hunting;  in  some 
dogs  when  penned  up  or  tied ;  during  the  course  of  rabies  and 
the  nervous  form  of  distemper;  excitement. 

(6)  Inhalations  of  dust,  dirt,  etc.;  injuries  (tight  collars, 
etc.).  Inhalations  of  gases  and  smoke;  irritating  drugs  and 
chemicals. 

(c)  Exposure  to  cold. 

(d)  Infections  (staphylococcus,  etc.)  and  during  the  course 
of  infectious  diseases  (rabies,  distemper,  etc.). 

(e)  Extension  of  inflammation  from  adjacent  parts. 
Pathology.— (a)  There  is  an  acute  inflammation  of  the 

mucous  membrane  which,  in  the  early  stages,  is  covered  by 
a  thin  serous  exudate  which  later  becomes  turbid  from  admix- 
ture of  leukocytes.  From  the  irritation  produced  by  cough- 
ing small  quantities  of  blood  are  often  raised.  When  infection 
is  present  the  secretions  are  mucopurulent  in  character. 


CHRONIC  LARYNGITIS  31 

(6)  The  discharge  contains  bacteria,  leukocytes,  red  cor- 
puscles and  epithelial  cells. 

Symptoms.—  Hoarseness,  change  of  voice,  frequent 
attempts  at  deglutition,  a  harsh,  dry  cough  which  later 
becomes  softer  and  moist  as  the  secretions  are  increased. 
The  mucous  membranes  are  congested  and  swollen.  Pressure 
on  the  larynx,  exercise,  excitement  or  drinking  cold  water 
induces  coughing.  General  symptoms  are  rare. 

Diagnosis.— The  presence  of  the  harsh,  dry  cough  which  is 
aggravated  by  exercise  and  excitement  and  the  absence  of 
general  disturbance  are  characteristic  of  laryngitis. 

Prognosis.— Favorable.  Recovery  usually  follows  in  eight 
to  ten  days,  unless  when  secondary  to  rabies,  distemper,  etc. 

Treatment.—  Hygienic.— Keep  warm;  supply  plenty  of 
fresh  air. 

Dietetic.— Give  warm  milk  and  warm  liquid  foods. 

Medical.— Direct  application  of  medicinal  preparations  to 
the  mucous  membrane  is  unpracticable  and  of  little  value. 
The  following  formula  should  be  used  to  allay  irritation  and 
stop  the  coughing : 

1$ — Morphini  hydrochlorati 0.1 

Aquae  amygdalae  amarse 

Misce  et  fiat  solutio. 

Sig. — Give  teaspoonful  three  times  daily. 

Surgical.— Apply  Priesnitz  compress  or  hot  antiphlogistin 
pack  over  the  larynx.  Renew  twice  daily. 

Chronic  Laryngitis. — Definition. — A  chronic  catarrhal  in- 
flammation of  the  mucosa  and  submucosa  of  the  larynx. 

Etiology.— This  is  usually  the  result  of  frequent  acute 
attacks,  and  therefore  the  causes  enumerated  under  acute 
laryngitis  are  applicable  to  the  chronic  form.  Chronic  laryn- 
gitis is  often  the  result  of  the  extension  of  chronic  nasal  and 
pharyngeal  catarrh;  the  presence  of  papillomata  and  poly- 
poid fibromata  within  the  larynx;  as  a  sequel  to  distemper; 
may  be  caused  by  pressure  on  the  vagus  nerve  (enlarged 
mediastinal  lymph  glands,  sarcomas,  carcinomas,  etc.); 
to  direct  irritation  of  the  mucosa  by  malignant  growths; 
enlarged  thyroids. 


32  DISEASES  OF  THE  LARYNX 

Pathology.— Chronic  catarrh  leads  to  hyperemia  of  the 
parts  with  hypertrophy  of  the  mucosa  and  the  submucosa, 
together  with  fibrous  tissue  proliferation.  Localized  thick- 
enings, either  flat  or  wart-like,  are  often  noticed.  The  sub- 
mucosa is  infiltrated  with  cells  and  the  mucous  glands  are 
swollen  and  distinct,  producing  a  granular  condition. 

Symptoms.— The  symptoms  are  somewhat  similar  to  those 
of  acute  laryngitis  but  not  so  severe  and  continue  for  a  longer 
time.  The  cough  is  hoarse,  dry,  seldom  moist,  and  is  aggra- 
vated by  exposure  to  cold,  exercise  or  excitement.  The 
larynx  is  less  sensitive  than  in  the  acute  form  when  examined 
by  external  manipulation.  After  severe  attacks  of  coughing 
the  patients  may  show  nausea  and  vomiting. 

Diagnosis.— The  chronic  course,  absence  of  general  symp- 
toms and  the  cough  characterize  the  condition. 

Prognosis.— Owing  to  the  changes  in  the  mucosa  and  the 
submucosa,  improvement  is  slow  and  complete  recovery 
seldom  takes  place. 

Treatment.—  Hygienic.— Keep  warm;  supply  plenty  of 
fresh  air. 

Dietetic.— Give  warm  liquid  foods  (milk,  soups,  etc.). 

Medical.— The  following  formulae  may  be  used  to  stop  the 
coughing  and  allay  the  irritation : 

H — Morphini  sulphatis 0.1 

Aquae  amygdalae  amarse 30.0 

Misce  et  fiat  solutio. 

Sig. — Give  teaspoonful  three  times  daily. 


1^ — Potassi  bromidi 10.0 

Morphini  sulphatis 

Aquse  distillata      . 150.0 

Misce  et  fiat  solutio. 

Sig. — Give  teaspoonful  three  times  daily. 

For  expectorant  action  may  use  the  following: 

1$ — Ammonii  chloridi 

Antimonii  et  potassi  tartras 

Extract,  glycyrrhizae  . 

Aquse  feniculae 

Misce  et  fiat  solutio. 

Sig. — Give  teaspoonful  every  eight  to  ten  hours. 


CHRONIC  LARYNGITIS  33 

or 

3 — Apomorphin.  hydrochloras 0.05 

Acidi  hydrochloric! 1.0 

Aquse  distillata 250.0 

Misce  et  fiat  solutio. 

Sig. — Give  teaspoonful  twice  daily. 

Syrup  of  tar  or  syrup  of  wild  cherry  may  be  given  in 
teaspoonful  doses  twice  daily. 

Inhalations  of  medicinal  preparations  (turpentine,  etc.) 
and  direct  applications  (silver  nitrate  1,  glycerin  130)  may 
be  used  in  some  of  the  more  obstinate  cases. 


CHAPTER  III. 

DISEASES  OF  THE  TRACHEA  AND  BRONCHIAL 
TUBES. 

Examination.— (a)  By  palpation,  the  upper  part  of  the 
trachea  can  be  examined  for  enlargements,  deformities  of 
the  tracheal  rings,  constrictions  and  sensitiveness  to  pressure. 
Often  when  inflammatory  conditions  are  present,  slight 
pressure  on  the  trachea  will  induce  coughing,  attempts  at 
swallowing  and  considerable  uneasiness  and  pain. 

(6)  By  auscultation,  the  condition  of  the  mucous  mem- 
brane and  the  character  of  the  secretions  can  be  determined. 
The  tracheal  and  bronchial  sounds  are  most  distinct  at  the 
entrance  of  the  trachea  to  the  thorax.  A  phonendoscope 
held  directly  against  the  trachea  at  this  point  will  greatly 
assist  in  the  examination. 

ACUTE  TRACHEITIS  AND  BRONCHITIS. 

Definition.— These  are  acute  inflammatory  conditions 
involving  the  mucous  membrane  of  the  trachea  and  the 
bronchial  tubes. 

Etiology.— (a)  Small  particles  of  foreign  bodies  (dust,  etc.) 
enter  the  trachea  and  bronchial  tubes  producing  excoriations 
and  congestion  of  the  mucous  membrane  which  allow  infec- 
tion to  take  place.  If  these  substances  are  putrescent  a  fetid 
bronchitis  will  be  produced. 

(6)  Irritating  gases  (ammonia,  etc.)  and  the  fumes  of 
acids  (carbolic,  etc.)  may  excite  an  attack  of  bronchitis  by 
direct  irritation  to  the  mucous  membrane.  When  inhaled 
in  concentrated  form  and  in  large  quantities  they  will  induce 
inflammation  extending  into  the  smaller  bronchioli  producing 
an  acute  capillary  bronchitis.  The  excretion  of  toxic  sub- 


ACUTE  TRACHEITIS  AND  BRONCHITIS  35 

stances  by  the  bronchial  mucosa  causes  a  rapid  proliferation 
of  the  surface  and  granular  epithelium  of  the  mucous  mem- 
brane and  an  increased  secretion  of  mucus.  The  epithelium 
of  the  mucous  membrane  becomes  more  embryonal  in  char- 
acter and  therefore  less  resistant  to  the  invasion  of  micro- 
organisms. At  the  same  time  these  organisms,  ordinarily 
present,  multiply  more  rapidly  and  increase  in  virulence,  and 
unless  the  process  is  arrested  a  bronchitis  is  soon  established. 
Some  drugs  (iodin,  bromin,  etc.)  when  administered  in  large 
doses  and  continued  for  quite  a  time  may  be  excreted  in 
sufficient  quantities  to  produce  an  acute  bronchitis. 

(c)  Inhalations  of  smoke  containing  various  gases  and 
particles  of  foreign  material  will  irritate  the  mucous  mem- 
brane of  the  entire  respiratory  tract,  frequently  resulting  in 
an  active  congestion  and  later  in  inflammation  of  the  mucous 
membrane  which  favors  the  growth  and  development  of  the 
infection  which  is  always  present. 

(d)  Acute  bronchitis  develops  frequently  as  a  secondary 
disease  following  specific  infections  (distemper,  etc.).    The 
specific  infection  reduces  the  normal  resistance  of  the  mucous 
membrane  thus  allowing  the  secondary  infection  (staphylo- 
coccus,  streptococcus)  to  develop  rapidly  and  produce  the 
disease. 

(e}  Parasitic.  In  severe  infestations  of  the  Uncinaria 
canina,  the  larval  form  of  this  parasite,  in  its  migrations 
through  the  body,  often  burrows  along  or  through  the  walls 
of  the  bronchi  and  trachea  producing  an  inflammation  of  the 
mucous  membrane  and  the  underlying  tissues.  (See  Unci- 
nariasis.) 

(/)  Tracheitis  and  acute  bronchitis  are  often  consecutive 
to  inflammations  of  the  nasal  passages,  larynx  and  pharynx. 
The  infection  is  carried  to  the  trachea  and  bronchi  by  inhala- 
tion where  it  develops,  producing  the  inflammation. 

(g)  Other  diseases  (renal  affections,  endocarditis,  diabetes, 
carcinomas  and  sarcoma,  valvular  insufficiency)  produce  a 
disturbance  of  the  heart  action,  enfeeblement  of  the  vaso- 
motor  nerve  and  reduce  the  resistance  of  the  mucous  mem- 
brane. 

It  is  quite  evident  that  acute  tracheitis  and  bronchitis 


36  DISEASES  OF  THE  TRACHEA 

in  most  cases  develop  from  bacteria  found  normally  on  the 
mucous  membrane. 

Pathology . —The  pathological  changes  that  are  liable  to 
be  found  in  acute  tracheitis  and  bronchitis  are  somewhat 
diverse,  the  details  of  the  process  being  considerably  modified 
by  the  anatomical  peculiarities  of  the  parts  affected  and  the 
different  causes  that  affect  them.  The  inflammation  may 
be  restricted  to  the  bronchial  structure  but  is  frequently 
associated  with  other  and  more  serious  disturbances.  The 
condition  is  usually  bilateral,  although  certain  parts  are 
affected  more  than  others.  Tracheitis  and  bronchitis  are 
often  associated  with  laryngitis,  peribronchitis  and  broncho- 
pneumonia. 

Symptoms.— Coug h.— This  is  the  most  important  symptom 
and  is  never  absent,  although  it  may  be  slight  or  very  severe 
and  loud,  occurring  as  isolated  coughs  succeeding  each  other 
with  greater  or  less  frequency,  or  in  paroxysms  which  often 
end  in  nausea  or  vomiting.  The  cough  is  dry  and  harsh  in 
the  early  stages,  later  becoming  moist  as  the  inflamed  mucous 
membranes  produce  an  increased  secretion.  Paroxysms  of 
coughing  are  often  induced  by  excitement  (visits  of  the  owner, 
etc.),  exposure  to  cold,  moist  air,  pressure  over  the  lower  part 
of  the  trachea  or  by  percussion  over  the  sides  of  the  chest. 
The  object  of  the  cough  is  to  expel  the  accumulated  discharge 
from  the  air  passages. 

Discharge,— This  is  always  present  except  in  the  early 
stages;  it  is  mucous  at  first,  becoming  mucopurulent  or  puru- 
lent as  the  disease  progresses.  In  small  animals  the  discharge 
is  expelled  from  the  trachea  and  bronchi  directly  into  the 
mouth  and  swallowed.  Therefore  it  is  impossible  to  deter- 
mine the  amount  and  character,  and  it  becomes  necessary 
to  observe  the  animal  while  coughing  to  ascertain  the  condi- 
tion of  the  discharge. 

Dyspnea.— The  degree  of  dyspnea  depends  on  the  obstruc- 
tion of  the  free  movement  of  air  through  the  bronchial  tubes. 
In  mild  cases  it  may  not  be  noticed  but  in  other  cases,  in 
which  the  calibre  of  the  bronchi  is  materially  decreased  by 
the  swelling  of  the  mucous  membrane,  it  may  be  quite  dis- 
tressing. 


ACUTE   TRACHEITIS  AND  BRONCHITIS  37 

General  Symptoms.— Moderate  temperature  (rise  of  l°-2°), 
pulse  quickened,  partial  loss  of  appetite  and  increased  thirst. 
In  severe  cases,  there  is  complete  loss  of  appetite,  high  tem- 
perature (104°-105°)  and  general  depression.  On  percussion 
nothing  abnormal  is  noted,  except  in  cases  where  the  bron- 
chioli  are  affected  and  filled  with  an  exudate  where  there  may 
be  local  areas  of  dulness. 

Auscultation.— In  mild  cases  the  vesicular  sound  is  in- 
creased. In  well  marked  cases  the  respiratory  sounds  are 
harsh  with  some  lengthening  of  expiration.  Absence  of  sound 
may  be  found  when  obstruction  of  the  bronchi  or  collapse 
of  lobules  occurs.  Sibilant  and  sonorous  sounds  are  typical 
signs  which  are  due  to  the  irregular  narrowing  of  the  calibre 
of  the  large  and  small  bronchi  respectively.  As  the  secretion 
becomes  more  liquid,  moist  rales  are  produced  in  the  tubes 
due  to  the  liquid  being  driven  back  and  forth  by  the  air 
currents.  The  volume  of  the  rale  is  in  proportion  to  the  size 
of  the  tube  in  which  it  originates.  Large,  moist,  bubbling 
rales  are  produced  in  the  large  bronchi,  and  the  small,  moist 
rales  arise  in  the  smaller  tubes. 

Diagnosis.— From  the  character  of  the  cough,  auscultation 
and  general  symptoms  one  may  readily  detect  the  presence 
of  acute  tracheitis  and  bronchitis.  Careful  examination  of 
the  animal  should  be  made,  however,  to  determine  if  the 
disease  is  primary  or  secondary. 

Prognosis.— Favorable  in  most  primary  cases;  when  secon- 
dary to  other  diseases  the  prognosis  is  not  so  favorable.  In 
primary  cases,  the  course  is  usually  eight  to  fourteen  days; 
in  secondary  it  is  much  longer. 

Treatment.—  Hygienic.— The  animal  must  be  kept  in  a 
warm  place  (70°  F.)  having  good  ventilation  but  direct 
currents  of  cold  air  must  not  reach  it. 

Dietetic.— Light,  soft  or  liquid  foods  should  be  used  (milk, 
extract  of  beef,  soups  or  small  amounts  of  raw  or  cooked 
beef).  In  cases  where  the  animal  will  not  eat,  it  should  be 
given  warm  milk  to  which  raw  eggs  .have  been  added. 

Medical.— Tor  the  appetite  use  compound  tincture  of 
gentian  (0.8-2.0)  or  tincture  of  nux  vomica  (0.3-0.0  drops). 
In  the  early  stages  while  the  cough  is  dry  and  harsh, 


4  /I  t?  /I 


38  DISEASES  OF  THE  TRACHEA 

expectorant  formulae  should  be  used  to  stimulate  the  secre- 
tion of  the  mucous  membrane,  as 

R — Ammonii  chloridi 5.0 

Extract,  glycyrrhizae .  10.0 

Aquae 150.0 

Misce  et  fiat  solutio. 

Sig. — Give  a  teaspoonful  three  times  a  day. 

or 

J$— Apomorphini  hydrochlorati 0 . 02 

Acidi  hydrochlorati 1 . 00 

Aquae  distillata 150.00 

Misce  et  fiat  solutio. 

Sig. — Give  a  teaspoonful  four  times  a  day. 

When  severe  cough  is  present,  sedatives  should  be  given 
to  reduce  the  irritation  to  the  nerve  endings  in  the  mucous 
membrane,  in  the  following  formula: 

Ifc — Morphini  sulphatis 0.2 

Aquae  amygdalae  amarse 20.0 

Aquae 150.0 

Misce  et  fiat  solutio. 

Sig. — Give  teaspoonful  every  three  hours. 

Counterirritants  (oil  of  mustard  and  glycerin  1-20)  may  be 
applied  to  the  walls  of  the  thorax  to  stimulate  the  enervation 
and  circulation  in  the  trachea  and  bronchi. 

Inhalations  of  antiseptics  and  stimulants  (oil  of  turpen- 
tine, oil  of  tar,  creolin,  etc.)  may  be  used.  These  are  best 
administered  by  adding  them  to  hot  water  and  allowing  the 
animal  to  inhale  the  vapor. 

In  the  treatment  of  this  disease  the  predisposing  causes 
should  be  considered  more  than  the  infection  as  antiseptics 
cannot  be  applied  to  produce  thorough  antiseptic  action  on 
the  mucous  membrane. 


BRONCHIAL  CATARRH  OF  BIRDS. 

Bronchitis. 

Definition.— An  acute  or  chronic  inflammatory  condition 
of  the  mucous  membrane  of  the  bronchial  tubes. 


BRONCHIAL  CATARRH  OF  BIRDS  39 

Etiology.—  This  often  occurs  from  the  extension  of  inflam- 
mation of  the  nasal  passages,  the  larynx  and  trachea.  Expos- 
ure to  dampness,  cold  draughts  of  air  and  to  sudden  and 
extreme  changes  of  temperature  are  predisposing  causes. 
Specific  infections  (infectious  nasal  catarrh,  tuberculosis); 
parasites  (Syngamus  trachealis)  ;  fungi  (aspergillus)  are  all 
exciting  causes  and  may  produce  an  extensive  and  severe 
bronchitis. 

Symptoms.  —The  birds  become  somewhat  stupid,  lose  appe- 
tite, show  accelerated  respirations  and  cough.  Later  the 
symptoms  grow  more  pronounced  inducing  severe  dyspnea, 
the  mouth  frequently  held  open  to  facilitate  respiration. 

Auscultation  reveals  a  blowing  or  whistling  sound  in  the 
bronchi,  which,  later,  as  the  secretions  accumulate,  is 
bubbling  or  rattling. 

Diagnosis.—  This  is  made  by  the  dyspnea,  cough,  stupidity 
of  the  patient,  and  the  course  of  the  disease. 

Prognosis.—  Favorable  unless  due  to  specific  infection  or 
parasites. 

Treatment.—  Hygienic.—  Keep  the  birds  in  a  warm  place 
which  is  well  ventilated  and  free  from  cold  draughts. 

Dietetic.—  Give  soft  and  nutritious  food  (stale  bread  and 
milk,  oatmeal  and  milk,  meat  scraps)  . 

Medical.—  Inhalations  of  vapors  from  boiling  water  con- 
taining sodium  bicarbonate  (2  per  cent.),  creolin  (2  per  cent.) 
or  carbolic  acid  (3  per  cent.). 

To  stimulate  the  bronchial  secretions  use  the  following: 

1$  —  Ammonii  chloridi         ......... 

Mellis    ........... 

Aquae  feniculi  ......... 

Misce  et  fiat  solutio. 

Sig.  —  Give  teaspoonful  three  to  four  times  daily. 

As  a  laxative  and  antiseptic: 


terebinthi  nse  •      •          °  40 

Oleiricini    ........ 

Misce  et  fiat  solutio. 

Sig.  —  Give  at  once  and  repeat  every  four  to  six  hours  until  a  laxative 
action  is  produced. 


40  DISEASES  OF  THE  TRACHEA 

In  treating  a  large  number  of  birds  encourage  the  appetite 
with  stomachic  tonics  (iron  sulphate)  in  the  food  and  drink- 
ing water. 

MYCOTIC  PNEUMONIA. 

Aspergillosis. 

Definition.— A  mycotic  disease  affecting  primarily  the 
respiratory  passages,  often  producing  bronchitis  and  pneu- 
monia. 

Etiology.— The  exciting  causes  are  species  of  fungi  belonging 
to  the  genus  Aspergillus.  These  fungi  exist  abundantly  in 
nature  upon  all  kinds  of  grain  especially  during  the  warm, 
moist  weather.  The  spores  are  inhaled  with  dust  or  taken 
with  food  and  lodge  on  the  mucous  membrane  where  they 
rapidly  develop  into  the  fungus,  which  causes  the  irritation. 
The  most  common  species  in  the  domestic  birds  are  the 
Aspergillus  fumigatus,  A.  nigrescens,  A.  glaucus  and  the 
A.  candidus. 

Other  species  are  rarely  found  in  the  respiratory  tract  of 
birds.  The  predisposing  factors  are  bronchitis,  affections 
of  the  lungs,  delicate  breeds  of  birds,  or  delicate  and  weak 
individuals. 

Pathology.— (a)  On  the  mucous  membrane  of  the  trachea 
and  bronchi  is  found  a  thick  membranous  mass  which  bears 
upon  its  surface  a  growth  of  the  fungus.  These  masses  are 
at  first  soft  but  become  firmer  with  age  and  are  yellowish  or 
greenish  in  color,  with  some  resemblance  to  a  fibrinopurulent 
exudate.  They  adhere  firmly  to  the  mucous  membrane 
which  is  thickened  and  congested.  These  growths  may 
obstruct  the  air  cells  and  the  smaller  bronchi,  often  being 
found  as  caseous  or  even  calcareous  nodules,  somewhat 
resembling  tuberculosis.  The  nodules  vary  in  size  from 
that  of  a  pinhead  to  a  pea  and  may  involve  the  greater  part 
of  the  lung  tissue.  Nodules  may  also  be  found  in  the  liver, 
intestines,  the  mesenteric  glands  or  other  organs.  In  very 
acute  cases  the  lungs  may  show  simply  an  acute  inflammation 
with  secondary  conditions  in  other  organs.  • 


MYCOTIC  PNEUMONIA  41 

(6)  Microscopic  examination  reveals  the  spores  or  fila- 
ments of  the  fungus  in  most  of  the  lesions,  either  acute  or 
chronic. 

Symptoms. — In  the  very  early  stages  no  symptoms  are 
noted,  and  it  is  only  after  the  disease  has  progressed  suffici- 
ently to  cause  obstruction  or  irritation  to  the  tissues  that 
symptoms  are  manifested.  The  affected  birds  become  weak 
and  depressed,  do  not  follow  the  flock;  the  plumage  is  rough. 
Respirations  are  accelerated  and  during  expiration  are  accom- 
panied by  a  rattling  or  snoring  sound.  The  mouth  is  held 
open  to  facilitate  breathing.  The  temperature  is  elevated, 
the  appetite  diminished  and  thirst  increased.  There  is  often 
a  greenish-yellow  discharge  from  the  nasal  passages.  The 
birds  soon  become  emaciated,  a  severe  diarrhea  develops,  and 
death  results  from  exhaustion. 

Diagnosis.— Made  by  finding  the  spores  or  fungi  by  a 
microscopical  examination  of  scrapings  taken  from  the 
affected  parts. 

Prognosis.— Very  unfavorable. 

Treatment.— Hygienic.— Keep  the  affected  birds  in  a  warm, 
well  ventilated  place. 

Dietetic.— Feed  concentrated  nutritious  food. 

Medical.—  Treatment  is  unsatisfactory  in  well  established 
cases.  Inhalations  of  antiseptics  as  tar  or  turpentine  are 
indicated.  These  substances  may  be  volatilized  with  boiling 
water  or  the  tar  by  placing  it  on  a  hot  surface.  The  affected 
birds  are  allowed  to  inhale  the  fumes  for  a  half  hour  every 
day.  Potassium  iodid  (.05-0.1  per  bird  daily)  is  also  indi- 
cated; sulphate  of  iron  (4.0  to  1000.0)  may  be  used  in  the 
drinking  water. 

Prevention.— The  healthy  birds  should  be  separated  from 
the  sick  ones  and  the  premises  disinfected  (lime  or  carbolic 
acid  5  per  cent.).  The  straw  and  grain  should  be  cleaned 
before  given  to  the  birds,  as  dust  is  the  common  carrier  of 
the  fungus.  Successful  disinfection  cannot  be  attained  as 
the  spores  occur  widely  distributed  in  nature.  Cleaning 
of  the  straw  and  grain  as  suggested  assists  in  eliminating  the 
fungus. 


42  DISEASES  OF  THE  TRACHEA 

ANIMAL  PARASITES  IN  THE  TRACHEA  AND  BRONCHIAL 

TUBES. 

Syngamosis.     Gapes  in  Chickens. 

Definition.— This  is  a  condition  due  to  the  Syngarnus 
trachealis  found  most  commonly  in  the  trachea  and  bronchi 
of  birds. 

Etiology.— The  only  cause  is  the  parasite  Syngamus 
trachealis,  genus  Syngamus.  This  is  a  small,  round  worm, 
red  in  color,  and  the  male  is  about  5  mm.  long  and  the  female 
5  to  20  mm.  A  remarkable  feature  of  these  worms  is  per- 
manent copulation,  which  is  so  intimate  that  the  males 
cannot  be  separated  from  the  females  without  tearing  their 
integuments.  This  arrangement  gives  the  worms  a  forked 
or  Y  appearance. 

They  attach  themselves  to  the  mucous  membrane  of  the 
trachea  and  larger  bronchi  and  suck  the  blood.  By  so  doing 
they  produce  considerable  irritation.  The  ova  of  the  syn- 
gamus  are  not  laid  but  pass  from  the  body  of  the  female 
which  suffers  rupture  and  usually  occurs  after  death. 
These  ova  are  hatched  in  from  one  to  six  weeks  according  to 
the  temperature  on  damp  ground  or  in  water.  The  embryo 
does  not  need  an  intermediate  host  in  order  to  become  trans- 
formed into  an  adult  worm.  Birds  ingest  the  embryos  along 
with  food  or  water  or  the  adult  worm  coughed  up  by  an 
affected  bird  may  be  swallowed;  earth  worms  in  infested 
yards  frequently  have  embryos  in  their  intestinal  tract  and 
when  these  are  swallowed  the  embryos  are  liberated.  They 
then  burrow  out  through  the  walls  of  the  esophagus  and 
stomach  and  migrate  through  the  tissues  or  possibly  ma  the 
blood  stream  until  they  reach  the  lungs  and  trachea.  It  has 
been  shown  that  fully  developed  parasites  can  be  found  in 
the  trachea  twelve  (lays  after  feeding  the  ova  to  healthy 
birds. 

Symptoms.— This  disease  is  seen  most  frequently  in  young 
birds  of  from  one  to  four  weeks  old,  and  is  especially  common 
in  chicks.  They  have  a  whistling  cough,  and  the  most 
seriously  affected  open  the  beak  at  the  same  time  stretching 


ANIMAL  PARASITES  IN   THE  TRACHEA  43 

the  neck  by  a  peculiar  movement  (gaping)  in  order  to  facili- 
tate inspiration.  The  general  signs  are  loss  of  appetite, 
dulness,  wings  pendant  and  all  evidence  of  cachexia.  Death 
results  from  exhaustion  or  asphyxiation. 

Diagnosis.— The  peculiar  gaping  movement  at  each  inspira- 
tion, sneezing,  and  distressed  breathing  as  from  obstruction 
in  the  trachea.  Finding  the  worms  in  the  trachea  or  eggs  in 
the  discharge  from  the  mouth  is  conclusive. 

Prognosis.— Unfavorable,  but  depends  upon  the  number 
of  parasites  present  in  the  trachea.  A  spontaneous  recovery 
is  rare,  especially  in  young  birds. 

Treatment.— All  of  the  young  birds  should  be  treated  as 
soon  as  the  disease  is  noticed.  As  much  garlic  as  they  can 
be  made  to  eat  when  chopped  fine  and  mixed  with  other  food, 
or  powdered  asafetida  (0.25  per  head  daily)  may  be  used. 
The  volatile  part  of  the  garlic  or  the  asafetida  is  eliminated 
with  the  expired  air  and  acts  as  a  toxicant  to  the  parasites 
in  the  trachea.  Individuals  may  be  treated  by  intratracheal 
injections  of  sodium  salicylate  (5  per  cent.)  using  1  c.c.  per 
bird  and  injected  with  a  medicine  dropper  directly  into  the 
trachea.  This  loosens  the  worms  and  they  can  be  coughed 
out.  In  cases  of  imminent  asphyxia  the  worms  may  be  with- 
drawn by  the  aid  of  a  feather,  having  the  barbules  all  removed 
except  at  the  end.  Or  a  horsehair  folded  and  twisted  so  as  to 
form  a  small  loop  may  be  used.  It  is  introduced  into  the 
trachea  through  the  open  mouth  and  turned  round  and 
round,  the  object  being  to  loosen  the  worms.  They  may  be 
then  withdrawn  with  the  feather  or  coughed  out.  This 
method  of  ridding  the  chick  of  the  parasite  is  dangerous  and 
insufficient,  and  can  remove  only  those  parasites  which  are 
slightly  attached  and  in  the  upper  part  of  the  trachea. 

Prevention.— Separate  the  sick  birds  from  the  healthy  and 
clean  up  all  coops,  pens  and  runways,  drinking  troughs,  etc. 
and  disinfect  with  carbolic  acid  (5  per  cent.) .  Lime  sprinkled 
freely  throughout  the  house  and  in  the  coops  will  aid  in 
keeping  them  clean.  Burn  all  dead  birds  and  provide  clean 
water  and  food. 


44  DISEASES  OF  THE  TRACHEA 

CHRONIC  TRACHEITIS  AND  BRONCHITIS. 

Definition.— This  is  a  chronic  inflammation  of  the  mucous 
membrane  of  the  trachea  and  bronchial  tubes. 

Etiology.— Chronic  tracheitis  and  bronchitis  may  occur 
independently  or  secondary  to  some  other  disease.  It  may 
originate  from  any  of  the  causes  of  acute  tracheitis  and 
bronchitis,  especially  when  their  action  is  persistent  or  fre- 
quently repeated.  The  common  causes  are: 

(a)  Continued  inhalation  of  irritating  dust,  dirt,  etc. 

(6)  Exposure  to  cold,  damp  air  (as  keeping  animals  in 
cold,  damp  basements  having  poor  ventilation). 

(c)  Parasitic.  In  severe  infestations  with  Ankylostoma 
canina,  when  the  animal  is  being  constantly  reinfested,  the 
passage  of  the  larvae  through  the  tracheal  and  bronchial 
structure  produces  a  chronic  irritation.  (See  Uncinariasis.) 
Chronic  tracheitis  and  bronchitis  often  result  from  the 
gradual  extension  of  the  inflammatory  process  from  the 
other  parts  (laryngitis,  pharyngitis,  etc.).  Many  cases  are 
secondary  to  special  diseases  such  as  distemper,  carcinoma, 
sarcoma,  rachitis  and  acute  valvular  insufficiency. 

Pathology.— Chronic  tracheitis  and  bronchitis  are  practi- 
cally always  purulent,  and  while  in  most  particulars  it 
closely  resembles  the  acute  form,  it  differs  from  it  in  the 
presence  of  a  more  deeply  penetrating  inflammation  and  in 
the  production  of  fibrous  tissue.  The  mucous  membrane 
is  swollen,  reddened,  infiltrated,  and  covered  with  purulent 
secretion.  The  walls  of  the  bronchi  are  hypertrophic.  Not 
infrequently  the  mucosa  is  thrown  into  little  polypoid  excres- 
cences, due  partly  to  contraction  and  partly  to  fibrous  prolif- 
eration. The  walls  of  the  bronchi  become  thickened  and 
there  is  often  a  fibrous  peribronchitis,  which  in  time  may 
lead  to  induration  of  the  lungs. 

Symptoms. —This  condition  is  most  common  in  old  animals 
where  it  frequently  interferes  with  respiration  producing 
so-called  asthma.  .  The  most  prominent  symptom  of  this  dis- 
ease is  the  cough.  It  is  usually  moist,  varying  in  intensity, 
depending  upon  the  amount  of  secretion  and  extent  of  mucous 
membrane  involved.  Excitement  frequently  produces  par- 


CHRONIC  TRACHEITIS  AND  BRONCHITIS  45 

oxysms  of  coughing  which  are  often  attended  by  severe 
nausea  and  vomiting.  In  cases  secondary  to  other  diseases 
the  cough  is  modified  becoming  short,  isolated  and  more 
spasmodic.  This  is  particularly  so  in  chronic  bronchitis  due 
to  the  parasite,  Uncinaria  canina,  and  to  valvular  insuf- 
ficiency of  the  heart.  The  discharge  is  mucopurulent  in 
character,  and  is  usually  swallowed,  but  during  paroxysms 
of  coughing  some  of  it  mixed  with  mucus  will  be  expelled 
from  the  mouth.  In  severe  cases  when  the  discharge  is 
decomposed  by  putrefaction  organisms  there  is  a  very  offen- 
sive odor  given  off  with  the  exhaled  air. 

Dyspnea. — This  is  always  present  to  some  extent;  in  old 
animals  it  is  well  marked.  The  dyspnea  results  from  the 
emphysema  and  interstitial  pulmonary  fibrosis  which  always 
develops,  and,  when  secretion  is  present  in  large  amounts, 
the  dyspnea  is  increased  accordingly,  producing  asthmatic 
conditions.  On  auscultation  there  are  sibilant  or  there  may 
be  moist  rales,  depending  on  the  condition  of  the  membranes 
and  the  character  and  quantity  of  the  secretion.  Vesicular 
sounds  are  increased.  Percussion  usually  gives  negative 
results,  and  only  in  the  more  severe  cases  are  the  general 
symptoms  of  emaciation,  loss  of  appetite,  etc.,  noted. 

Diagnosis.— The  long  continued  course  of  the  disease,  the 
age  of  the  animal,  the  absence  of  general  symptoms  in  most 
cases  and  the  characteristic  cough  are  indicative. 

Prognosis. — In  most  cases  of  chronic  tracheitis  and  bron- 
chitis the  prognosis  should  be  considered  unfavorable  as 
complete  recovery  seldom  takes  place.  During  the  warm, 
dry  months  the  symptoms  often  subside  only  to  reappear 
with  the  return  of  the  cold,  damp  weather. 

Treatment.— Symptomatic  treatment  can  be  used  to  alle- 
viate the  cough  and  to  modify  the  secretions.  The  following 
formula?  may  be  used: 

T$ — Apomorphinse  hydrochlorati        .... 

Syrupus  pruni  virginianse 

Syrupus  picis  liquidaj 

Misce  et  fiat  solutio. 

Sig. — Give  tcaspoonful  three  times  daily. 

1$ — Acidi  henzoici 

Sacchari  albse 

Misce  et  fiat  pulvis  No.  XX. 

Sig. — Give  a  powder  morning  and  evening. 


46  DISEASES  OF  THE  TRACHEA 

In  general  debilitated  conditions  tonics  and  alteratives 
should  be  used  as  in  the  following  formula: 

1$ — Ferri  et  quinini  citratis 10.0 

Syrupi         90.0 

Misce  et  fiat  solutio. 

Sig. — Give  teaspoonful  once  daily. 

or 

!$ — Tincture  nuces  vomicse 7.0 

Tincture  gentianise 10.0 

Aquae 60.0 

Misce  et  fiat  solutio. 

Sig. — Give  teaspoonful  once  daily. 

Daily  inhalations  of  medicated  vapors  (turpentine,  creolin, 
etc.)  are  valuable  to  stimulate  the  secretions  and  assist  in 
their  removal. 


CHAPTER  IV. 
DISEASES  OF  THE  LUNGS. 

Examination. — The  following  things  are  essential  for  a 
complete  and  thorough  examination: 

1 .  The  number  and  character  of  the  respiratory  movements. 

2.  The  size,  shape  and  sensitiveness  of  the  thorax. 

3.  Auscultation. 

4.  Percussion. 

1.  Respiration. — In  small  animals  the  number  of  respira- 
tory  movements   normally   varies   greatly.     The   average 
number  while  at  rest  is  12-24.    This  is  easily  and  quickly 
increased  by  excitement  and  exercise  until  they  may  reach 
60-90  per  minute.    During  warm  weather  even  while  at  rest 
the  respirations  are  greatly  accelerated,  owing  to  the  skin 
glands  not  being  active  enough  to  assist  in  the  respiratory 
function.     In  order  to  overcome  this  physiological  condi- 
tion the  animal  breathes  forcibly  through  the  mouth,  and  the 
frequency  of  respirations  is  increased.     Respiratory  move- 
ments are  also  increased  in  the  following  diseased  conditions: 
Catarrhal    pneumonia,   foreign  body  pneumonia,    chronic 
interstitial   pneumonia,   usually  when  the  temperature  is 
elevated,  in  laryngitis,  acute  and  chronic  bronchitis,  hydro- 
thorax,   pleurodynia,   ascites,   peritonitis,   valvular   insuffi- 
ciencies, eclampsia  and  during  the  early  stages  of  some  poi- 
sonings.   A  lessening  in  the  number  of  respirations  is  found 
in  narcotic  poisoning,  diseases  of  the  brain  and  its  membranes 
and  in  the  later  stages  of  infectious  diseases,  septicemia  and 
pyemia. 

2.  The  Thorax.— In  shape  both  sides  of  the  chest  wall 
should  be  symmetrical.     Depression  on  one  side  indicates 
fractured  ribs  or  pleurodynia.    Distention  of  the  thorax  is 
seen  in  hydrothorax,  and  in  fluid  accumulations  (ascites), 
tumors  or  when  the  stomach  is  distended,  causing  pressure 
against  the  diaphragm. 

3.  Auscultation  is  practised  by  using  the  phonendoscope 
or  by  covering  the  thoracic  wall  with  a  piece  of  cloth  against 


48  DISEASES  OF  THE  LUNGS 

which  the  ear  is  placed.  With  the  phonendoscope  the  sounds 
are  made  more  audible  and  distinct. 

The  normal  sounds  of  the  lungs  are:  (a)  The  vesicular; 
(6)  bronchial,  and  (c)  the  expiratory,  (a)  The  vesicular  sound 
normally  is  a  soft,  regular,  blowing  sound  caused  by  the  air 
passing  into  the  alveoli  and  distending  them.  It  is  most  dis- 
tinct in  emaciated  animals  and  where  the  lung  tissue  is  in  close 
contact  with  the  thoracic  walls.  It  is  normally  increased  by 
excitement  or  exercise  and  is  always  more  distinct  in  puppies 
than  in  older  dogs.  The  vesicular  sound  is  modified  in  the 
following  pathological  conditions:  Increased  in  dyspnea  in 
the  healthy  portion  of  the  lung,  in  tracheitis  and  in  bronchitis; 
decreased  in  stenosis  of  the  upper  air  passages;  in  certain 
stages  of  catarrhal  pneumonia;  emphysema  of  the  lungs; 
hydrothorax;  swelling  and  thickening  of  the  skin  and  muscles 
of  the  thorax  and  in  certain  poisonings. 

(6)  Bronchial  respiratory  sounds  are  best  recognized  by 
placing  the  phonendoscope  directly  over  the  trachea  at  its 
entrance  to  the  chest.  These  sounds  are  normal  in  the  larynx 
and  trachea,  but  their  appearance  in  the  thorax  is  significant 
of  disease.  Bronchial  respiratory  sounds  are  increased  by 
secretions  in  the  smaller  bronchi,  as  in  catarrhal  pneumonia; 
compression  of  the  lungs  by  pleuritic  exudate;  laryngitis, 
tracheitis  and  bronchitis. 

Irregular  bronchial  sounds  are  caused  by  the  secretions 
being  carried  to  and  fro  by  the  passage  of  the  air.  They  are 
dry  (wheezing)  where  there  is  a  small  quantity  of  mucus 
adherent  to  the  mucous  membrane.  These  sounds  (wheezing) 
occur  mostly  in  the  smaller  bronchi,  while  the  moist,  bubbling 
rales  (sonorous)  emanate  from  the  larger  bronchi  where  they 
are  produced  by  the  collection  of  secretions.  Cavities  in  the 
lungs  also  produce  them.  Bronchial  sounds  are  important 
in  determining  the  existence,  extent  and  character  of  trache- 
itis and  bronchitis.  When  sibilant  (wheezing)  sounds  are 
prominent  it  indicates  that  the  infection  extends  into  the 
bronchioli. 

(c)  Expiratory  sounds  are  produced  by  the  rapid  expulsion 
of  air  from  the  lungs,  and  in  normal  conditions  are  hardly 
perceptible,  except  in  puppies.  This  sound  is  increased  by 


CONGESTION  OF  THE  LUNGS  49 

excitement,  exercise,  etc.     In  some  diseases  it  is  varied  in 
tone,  becoming  louder  and  more  prolonged. 

4.  Percussion.—  This  is  performed  by  the  use  of  the  per- 
cussion hammer  and  pleximeter  or  by  one  hand  placed 
against  the  chest  wall  and  tapped  with  the  fingers  of  the 
other  hand.  The  normal  sounds  of  a  healthy  lung  are  heard 
all  over  the  thorax,  the  volume  of  sound  depending  on  the 
thickness  of  the  lung  at  the  particular  part  being  examined. 
The  normal  sound  is  clear,  loud  and  resonant  as  distinguished 
from  the  tympanitic,  dull  or  solid  sound  of  disease.  Tym- 
panitic  sounds  are  heard  in  the  following  conditions:  (a) 
Emphysema,  (6)  pneumothorax,  (c)  cavities  in  the  lungs, 
(d)  in  collapse  of  the  pulmonary  tissue  from  a  retraction  of 
the  lungs  in  the  presence  of  pleuritic  exudates.  The  col- 
lapsed lung  floats  upon  the  surface  of  the  fluid  above  the  line 
of  dulness  and  on  percussion  emits  a  tympanitic  sound,  (e) 
In  the  first  and  last  stages  of  pneumonias.  Dull  or  flat 
sounds  are  heard  over  hepatized  areas  of  the  lungs,  chronic 
interstitial  pneumonia;  tumors  in  the  lungs,  and  hydro- 
thorax. 

CONGESTION  OF  THE  LUNGS. 

Hyperemia  of  the  Lungs. 

Definition. —An  excessive  or  abnormal  accumulation  of 
blood  in  the  lungs.  Hyperemia  may  be  either  active  or 
passive. 

Active  Congestion.— Etiology.— It  is  found  in  the  early 
stages  of  all  inflammatory  conditions  of  the  lungs  and  pleura. 
Occasionally  it  may  be  due  to  inhalations  of  irritating  gases, 
smoke,  acid  fumes,  etc.,  or  may  result  from  cold. 

Pathology.— The  lungs  are  dark  red  in  color;  on  cross- 
section  blood  escapes  from  the  cut  surface.  The  tissue  will 
float  in  water. 

Symptoms.— Active  congestion  of  the  lungs  is  characterized 
by  its  sudden  onset,  beginning  as  a  rule  with  a  chill  and 
rapidly  developing  dyspnea  accompanied  by  a  short,  dry 
cough  and  a  rapid,  full  pulse.  The  animal  often  assumes  a 
sitting  posture  with  elbows  held  outwardly,  ribs  elevated 
4 


50  DISEASES  OF  THE  LUNGS 

and  cheeks  inflated  at  each  expiration.  The  temperature 
may  rise  to  103°-104°  F.,  possibly  higher,  but  it  does  not 
persist,  falling  by  crisis  in  three  or  four  days.  Owing  to  the 
aeration  of  the  lungs  being  diminished  the  visible  mucous 
membranes  become  cyanotic.  On  auscultation  the  respira- 
tory sounds  will  be  increased,  harsh  and  rough,  and  rales  of 
various  kinds  may  be  heard.  At  the  base  of  the  lung  fine 
crepitant  or  subcrepitant  rales  may  be  distinctly  audible, 
while  over  other  parts  sibilant  or  sonorous  rales  may  be  heard. 
Percussion  reveals  only  slight  dulness. 

Diagnosis.— Active  congestion  of  the  lungs  in  the  beginning 
possesses  no  distinctive  characteristics,  but  resembles  broncho- 
pneumonia.  As  it  progresses  it  will  be  readily  distinguished 
from  this  condition  by  the  absence  of  hepatization  and  the 
occurrence  of  the  crisis  on  the  fourth  or  fifth  day. 

Prognosis.— Usually  favorable  but  in  some  cases  pulmonary 
edema  with  fatal  results,  or  pneumonia  may  develop.  The 
affection  is  always  to  be  looked  upon  as  serious  and  one 
demanding  active  treatment. 

Treatment.— Hygienic.— The  animal  must  be  kept  in  a  warm 
place  and  it  is  important  that  it  be  well  ventilated. 

Dietetic.— Give  warm  liquid  foods  (milk,  beef  tea,  soups, 
etc.). 

Medical.—  Magnesium  sulphate  (8.0-10.0  in  cold  water) 
should  be  used  as  a  hydragogue  purgative.  To  equalize  the 
circulation  tincture  of  aconite  (0.01-0.1)  or  veratrum  viride 
(0.1-0.2)  is  beneficial  and  can  be  given  every  three  to  five 
hours  if  necessary.  Oil  of  mustard  and  glycerin  (1-20)  can 
be  applied  to  the  walls  of  the  thorax  as  a  counterirritant. 
When  the  initial  intensity  of  the  symptoms  yields,  then  a 
stimulating  expectorant  as  ammonium  chlorid  should  be  used 
as  follows: 

I^ — Ammonii  chloridi 5.0 

Extract,  glycyrrhizae 10.0 

Aquae 150.0 

Misce  et  fiat  solutio. 

Sig. — Give  a  teaspoonful  three  times  a  day. 

Passive  Congestion.— Etiology.— This  results  from  obstruc- 
tion to  the  free  outflow  of  the  blood  from  the  lungs  to  the 


CONGESTION  OF  THE  LUNGS  51 

heart.  It  is  nearly  always  due  to  the  lack  of  force  or  faulty 
action  of  the  heart,  as  stenosis  or  insufficiency  of  the  mitral 
valve,  dilation  of  the  right  ventricle,  or  fatty  degeneration. 
It  may  also  be  caused  by  pressure  on  the  pulmonary  veins 
by  tumors,  etc.  In  the  latter  stages  of  long  continued  dis- 
eases or  in  any  febrile  condition  when  the  heart  action  is 
slowed,  the  blood  gravitates  to  the  lower  part  of  the  lung 
producing  a  hypostatic  congestion. 

Pathology. —The  lung  is  somewhat  enlarged,  its  consistency 
increased,  of  a  dark  red  color,  and  on  section  venous  blood 
escapes.  When  the  condition  has  persisted  for  a  long  time, 
the  lung  becomes  brown,  dense  and  firm,  due  to  a  deposit 
of  blood  pigment  and  a  proliferation  of  fibrous  tissue  in  the 
septa  of  the  lung,  a  condition  known  as  brown  induration. 

Symptoms.— Dyspnea  and  a  short,  hard  and  usually  dry 
cough  which  has  a  tendency  to  become  worse  with  exercise 
or  excitement.  The  bronchial  discharge  varies  in  amount 
and  in  some  cases  may  contain  blood.  Auscultation  reveals 
rales.  On  percussion  only  slight  dulness  may  be  noted. 
The  membranes  are  cyanotic. 

Diagnosis. —The  dyspnea,  cyanosis,  characteristic  cough 
and  shallow  respirations  without  rise-  of  temperature  are 
indicative. 

Prognosis.— Unfavorable,  depending  upon  the  cause  and 
extent. 

Treatment.— In  the  treatment  of  passive  congestion  of  the 
lungs,  medicinal  agents  directed  against  the  causative  cardiac 
affection  are  the  ones  which  will  most  favorably  influence 
the  pulmonary  condition.  As  a  heart  stimulant  the  following 
formula  gives  good  results: 

R — Extract!  digitalis  fluidi 1.0 

Syrupus  pruni  virginianse 60.0 

Misce  et  fiat  solutio. 

Sig. — Give  one  teaspoonful  once  a  day. 

In  addition  to  this  formula  strychnin  sulphate  (0.001 
daily)  may  be  used  as  a  general  stimulant.  To  relieve  the 
cough  when  severe  use: 

1$ — Morphini  sulphatis     . 

Aquae  amygdalae  amarse  . 
Misce  et  fiat  solutio. 
Sig. — Give  a  teaspoonful  twice  daily. 


52  DISEASES  OF  THE  LUNGS 

If  the  animal's  condition  will  permit  the  use  of  a  hydra- 
gogue  purgative,  magnesium  sulphate  (8.0-10.0)  is  useful  to 
modify  the  circulation  and  remove  fluid  from  it.  This  dose 
may  be  repeated  in  twelve  hours  if  sufficient  action  has  not 
taken  place. 

PULMONARY  EDEMA. 

Edema  of  the  Lungs. 

Definition.— An  effusion  of  serous  fluid  into  the  alveoli  and 
interstitial  tissue  of  the  lungs. 

Etiology.— Diseases  of  the  heart  (valvular  insufficiency, 
etc.)  are  the  most  frequent  predisposing  causes  of  pulmonary 
edema,  although  it  occurs  as  a  secondary  condition  to  chronic 
pulmonary  congestion,  nephritis,  cachexia,  anemia  and  infec- 
tious diseases  (distemper,  etc.).  In  the  latter  stages  of  dis- 
temper pulmonary  edema  frequently  develops  when  it  is 
often  the  immediate  cause  of  death.  Edema  of  the  lungs 
occasionally  follows  the  administration  of  drugs  (pilocarpin, 
etc.) . 

Pathology.— The  lung  is  heavier  and  firmer  than  normal, 
pale  in  color  and  pits  on  pressure.  When  incised  a  thin 
serous  fluid  escapes.  This  may  be  clear  or  if  there  is  conges- 
tion present  it  may  be  stained  with  blood.  Crepitation  is 
always  lessened  and  small  patches  may  be  entirely  airless. 
The  bronchi  contain  a  frothy  fluid. 

Symptoms.— The  symptoms  develop  rapidly  except  in 
those  cases  occurring  as  the  terminal  event  in  exhaustive 
diseases  in  which  the  course  is  more  gradual  and  the  symp- 
toms less  pronounced.  Severe  dyspnea,  which  becomes 
worse  as  the  exudate  accumulates  is  an  important  symptom. 
The  pulse  is  weak  and  small,  the  visible  mucous  membranes 
are  cyanotic  and  the  extremities  cold.  A  short,  feeble  cough 
often  accompanies  the  condition.  The  temperature  is  sub- 
normal. There  may  be  a  frothy  nasal  discharge.  Upon 
auscultation  various  kinds  of  rales  (fine,  course  or  bubbling) 
will  be  heard.  Percussion  reveals  diminished  normal  reso- 
nance with  occasional  small  areas  of  tympany,  especially  over 
the  posterior  part  of  the  lungs. 


BRONCHOPNEUMONIA  53 

Diagnosis.— The  sudden  onset,  severe  dyspnea  and  the 
absence  of  temperature,  accompanied  by  moist,  bubbling 
rales  on  auscultation  are  indicative. 

Prognosis.— Always  unfavorable,  depending  upon  the  cause. 
Recovery  may  occur  in  mild  acute  cases. 

Treatment.— Treatment  must  be  directed  first  to  relieve 
the  edema  which  threatens  the  life  of  the  animal,  and  sec- 
ondarily to  overcome  the  cause.  For  the  first  purpose  use 
counterirritation  to  the  walls  of  the  thorax,  oil  of  mustard 
and  glycerin  (1-20)  or  Priesnitz  compress  (applied  hot) ;  also 
strychnin  sulphate  (0.001  subcutaneously)  as  a  heart  stimu- 
lant. Subcutaneous  injections  of  ether  (0.8),  or  camphor 
(0.1)  in  ether  (0.8)  are  often  useful  as  prompt  stimulants. 
Atropin  (0.002)  is  of  value  as  a  heart  stimulant  and  is  espe- 
cially useful  in  cases  of  edema  due  to  pilocarpin,  being  a 
physiological  antidote. 

In  the  treatment  for  the  removal  of  the  cause  digitalis 
fluidextract  (0.1)  is  most  valuable  to  regulate  the  heart 
action.  Hydragogue  purgation  (magnesium  sulphate  8.0- 
12.0)  will  remove  fluid  from  the  blood  which  tends  to  reduce 
the  exudation  of  serum  into  the  lungs;  also  the  use  of  a  diuretic 
(oil  of  juniper  0.3-0.5)  for  the  same  purpose  in  cases  of  renal 
disease. 

BRONCHOPNEUMONIA . 

Catarrhal  Pneumonia. 

Definition.— This  is  an  affection  of  the  lungs  in  which  the 
usual  sequence  of  events  is,  that  an  inflammation  of  the 
smaller  bronchioles  in  scattered  areas  is  succeeded  by  the 
involvement  of  anatomically  related  or  contiguous  vesicles. 

Etiology.  — (a)  The  inhalation  of  foreign  material  in  the 
form  of  small  particles  of  dirt,  dust,  etc.,  which  irritates  the 
mucous  membrane  and  modifies  the  secretions,  favors  the 
development  of  infection  and  leads  to  inflammation  of  the 
bronchioli  and  alveoli. 

(b)  Irritating  chemicals  and  gases  when  inhaled  produce 
an  active  congestion  and  inflammation  of  the  lungs.  How- 
ever, in  most  cases  when  inhaled  in  large  quantities  they  act 


54 

as  irritants  to  the  mucous  membrane  and  thus  favor  the 
development  of  infection  which  leads  to  hronchopneumonia. 

(c)  Cold,  damp,  changeable  weather  is  a  very  important 
predisposing  factor  inasmuch  as  chilling  the  surface  of  the 
animal's  body  modifies  the  circulation  and  the  secretions  of 
the  mucous  membrane,  reducing  its  resistance,  as  well  as  the 
general  resistance  of  the  body.    This  favors  the  growth  of 
infection  which  may  be  already  present.    The  effect  of  cold, 
damp  weather  is  well  shown  by  the  greater  incidence  of  the 
disease  in  the  winter  and  spring  months.    Young  puppies, 
especially,  are  quite  frequently  affected  with  bronchopneu- 
monia  when  kept  in  cold,  damp  and  poorly  ventilated  kennels. 

(d)  Bronchopneumonia  is  frequently  secondary  to  specific 
infections  (distemper,  etc.)  which  reduces  the  general  as  well 
as  the  local  resistance. 

(e)  Inflammation  of  other  parts  of  the  respiratory  system 
may  produce  bronchopneumonia  by  an  extension  of  the 
inflammation.     This  is  especially  true  of  acute  bronchitis 
which  by  extension  at  first  produces  a  capillary  bronchitis 
and  later  a  bronchopneumonia. 

(/)  During  the  course  of  some  diseases  (nephritis,  endo- 
carditis, diabetes,  valvular  insufficiencies,  sarcomas  and 
carcinomas),  the  heart  action  is  disturbed,  the  vasomotor 
nerve  is  enfeebled,  both  of  which  reduce  the  resistance  to 
infection.  Young  puppies  infested  with  parasites,  which 
interfere  with  the  general  nutrition,  frequently  develop 
bronchopneumonia  from  the  reduced  resistance  to  infection. 

(gr)  Infectious  material  from  the  mouth  and  the  nasal 
passages  which  reach  the  bronchial  tubes  and  alveoli  will 
produce  a  bronchopneumonia. 

Possibly  in  no  other  disease  do  lessened  powers  of  resist- 
ance of  the  animal,  from  whatever  cause,  play  such  an  impor- 
tant part  in  determining  the  inception. 

Pathology.— The  process  in  bronchopneumonia  is  associated 
with  bronchitis,  and  indeed  almost  always  starts  with  an 
inflammation  of  the  smaller  bronchioles,  which  then  spreads 
to  the  adjacent  alveoli.  The  exudate  is  at  first  serous  and 
contains  a  few  erythrocytes,  but  more  numerous  white  cells. 
There  is  also  a  large  number  of  mononuclear  cells  with  clear 


BRONCHOPNEUMONIA  55 

protoplasm,  which  are  swollen  desquamated  epithelial  cells 
from  the  alveolar  walls.  The  disease  usually  affects  both 
lungs,  but  may  involve  only  one  or  even  a  single  lobe  or  a 
portion  thereof.  The  affected  organ  is  heavier  than  normal, 
somewhat  congested,  and  in  its  substance  can  be  felt  areas 
of  increased  consistence.  These  are  friable,  of  a  reddish- 
gray,  gray  or  grayish-yellow  color,  contrasting  somewhat 
with  the  rest  of  the  lung. 

On  pressure  a  turbid  fluid  can  be  expressed,  in  which  can 
be  seen  small  particles  of  a  gray,  grayish-yellow,  or  purulent 
appearance.  From  the  sporadic  distribution  of  the  consoli- 
dated areas,  the  term  "  splenization"  has  been  given  to  the 
condition.  On  section  of  the  lung,  both  red  and  gray  stages 
are  recognized.  The  smaller  bronchi  and  bronchioli  show 
inflammation  and  are  filled  with  exudate.  In  the  alveolar 
spaces  the  exudate  consists  mainly  of  serum,  a  few  red  cells, 
abundant  leukocytes  and  desquamated  cells.  The  latter  fre- 
quently contain  pigment  and  bacteria.  In  the  form  due  to 
inhalation  of  infective  material,  or  foreign  bodies,  the  exudate 
is  usually  purulent.  Such  a  condition  leads  to  a  diffuse  puru- 
lent infiltration  of  the  lungs  and  abscess  formation.  Occa- 
sionally gangrene  of  some  of  the  lung  tissue  will  be  noted. 
This  is  especially  true  in  weak  and  debilitated  animals  with 
general  circulatory  disturbance. 

Symptoms.— The  symptoms  of  primary  bronchopneumonia 
develop  rapidly,  usually  beginning  with  a  chill  and  the  animal 
appears  depressed  and  restless.  The  temperature  is  high 
(104°-105°  F.)  and  falls  by  crisis.  Dyspnea  is  pronounced, 
the  respirations  being  short,  shallow  and  very  rapid,  inflating 
the  cheeks  at  each  expiration.  A  short  painful  cough  is 
noticed  and  the  pulse  is  accelerated  (180-200).  On  auscul- 
tation the  sounds  are  mostly  those  of  an  acute  bronchitis 
(impairment  of  the  vesicular  murmur,  moist  sibilant  or 
sonorous  rales).  On  percussion  dulness  is  noted  where  there 
is  a  large  area  of  consolidation,  while  in  cases  where  the  con- 
solidated areas  are  scattered  compensatory  emphysema  may 
overcome  the  dulness.  In  the  secondary  forms  following 
other  diseases  (bronchitis,  distemper,  etc.)  the  onset  is  less 
severe  and  the  symptoms  less  pronounced.  The  cough  and 


56  DISEASES  OF  THE  LUNGS 

high  temperature  may  be  absent,  but  if  temperature  be 
present  it  falls  by  lysis.  Dyspnea  is  usually  seen  indicating 
a  lack  of  aeration  of  the  lungs.  In  the  course  of  this  secon- 
dary bronchopneumonia  the  symptoms  are  not  well  marked 
and  depend  largely  upon  the  primary  disease. 

Diagnosis.— This  is  made  in  the  primary  form  by  the  sudden 
onset  with  severe  dyspnea,  cough  and  high  temperature, 
while  in  the  secondary  form  the  symptoms,  not  being  char- 
acteristic, the  diagnosis  is  more  difficult,  depending  mostly 
upon  the  dyspnea  with  its  attending  conditions. 

Prognosis.— Unfavorable.  In  the  primary  form  the  prog- 
nosis is  determined  by  the  extent  of  the  inflammatory  process 
in  the  lungs,  while  in  the  secondary  form  it  depends  upon  the 
causative  disease,  and  as  this  is  usually  distemper  the  mor- 
tality is  high. 

Treatment.  —  Hygienic.—  The  animal  should  be  kept  in  a 
warm,  well  ventilated  room  free  from  cold  draughts. 

Dietetic.—  The  animal's  strength  should  be  sustained  by  the 
use  of  appetizing  foods  (milk,  beef  extract,  etc.)  given  warm 
in  small  quantities  every  few  hours.  During  convalescence 
small  amounts  of  lean  meat  or  other  nutritious  food  may  be 
given  3  or  4  times  a  day. 

Medical.—  At  the  onset  a  purgative  should  be  given 
(calomel  0.03  and  sodium  bicarbonate  0.5)  to  produce  free 
purgation  and  stimulate  the  activity  of  the  kidneys.  Expec- 
torants are  useful  to  modify  and  aid  in  expelling  the  discharge 
from  the  bronchial  tubes. 

1$ — Ammonii  chloridi 10.0 

Extract,  glycyrrhizse 20.0 

Aquse 150.0 

Misce  ct  fiat  solutio. 

Sig. — Give  teaspoonful  four  times  daily. 

Counterirritants  to  the  walls  of  the  thorax  in  the  form 
of  oil  of  mustard  and  glycerin  (1-20)  or  Priesnitz  compress 
applied  hot  around  the  chest.  The  heart  action  should  be 
stimulated  in  severe  cases  by  the  use  of  digitalis  fluid-extract 
(0.08-0.1)  and  for  general  stimulation  use  strychnin  (0.001). 
Inhalations  of  medicated  vapors  (turpentine,  oil  of  tar, 
creolin  in  hot  water)  are  useful  to  stimulate  the  mucous 
membrane  and  to  produce  antiseptic  action. 


CIRRHOSIS  OF  THE  LUNGS  57 

CIRRHOSIS  OF  THE  LUNGS. 

Chronic  Interstitial  Pneumonia. 

Definition.— A  chronic  inflammatory  condition  of  the  lungs 
characterized  by  an  increase  in  the  interstitial  tissue  and 
fibroid  collections  in  the  alveoli. 

Etiology.  — (a)  Inhalation  of  particles  of  dust  when  con- 
tinued for  a  long  period  produces  h'brosis  of  the  lungs,  due 
to  the  chronic  irritation  of  the  foreign  material  in  the  tissues. 
The  degree  depends  upon  the  amount  and  character  of  the 
inhaled  material. 

(6)  Pressure  upon  the  lungs  by  neighboring  structures,  as 
new  growths  and  diverticula  of  the  esophagus,  tumors  in 
the  lung  substance,  all  of  which  produce  a  reactive  inflamma- 
tion resulting  in  increased  connective  tissue  proliferation. 

(c)  One  of  the  most  frequent  causes  in  small  animals  is 
bronchopneumonia.     When  it  terminates  atypically  fibroid 
changes  occur  in  some  of  the  involved  lobules.     In  these 
cases  the  fibrosis  begins  as  a  chronic  bronchitis  or  peri- 
bronchitis,  invading  later  the  surrounding  parenchyma  of  the 
lung,  which  results  in  a  great  increase  in  the  interstitial 
tissue.     This   is   a   frequent   sequel   to  bronchopneumonia 
occurring    during    the   course    of    infectious   diseases    (dis- 
temper,   etc.).      For   some   unexplained    reason   resolution 
does  not  occur,  and  the  fibrinous  exudate  collected  in  the 
alveoli  during  the  stage  of  red  hepatization  is  displaced  by 
fibrous  tissue.    The  connective  tissue  formation  necessarily 
begins  in  the  alveolar  walls,  as  from  this  source  must  be 
derived  the  new  vessels  which  appear  in  the  intra-alveolar 
new  formations.     Proliferative  changes  in  the  alveolar  epi- 
thelium may  for  a  time  be  active  during  this  transformation 
of  the  exudate,  but  eventually  the  new  tissue  within  the 
alveoli  merges  with  the  thickened,  enclosing  walls,  which 
take  a  relatively  inactive  part  in  the  process,  and  the  area 
becomes  entirely  fibroid.    Usually  this  lesion  is  only  in  parts 
of  the  lobules,  but  in  some  cases  may  extend  into  a  consider- 
able portion  of  the   lung  tissue,  involving  the  interstitial 
connective  tissue  which  is  greatly  increased  in  amount. 

(d)  Localized  areas  of  interstitial  pneumonia  may  originate 


58  DISEASES  OF  THE  LUNGS 

from  abscesses  in  the  lungs,  sarcomas  and  carcinomas,  or 
from  inflammatory  reactions  from  the  pleura. 

Pathology.— Cirrhosis  is  characterized  by  the  overgrowth 
of  connective  tissue  in  the  lungs  so  that  they  become  hard, 
traversed  by  fibrous  bands,  and  more  or  less  shrunken.  The 
condition  leads  to  destruction  of  the  alveolar  spaces,  some- 
times with  bronchiectasis,  and  always  to  marked  impair- 
ment of  function.  When  due  to  lobular  pneumonia,  which 
is  the  common  form  of  pneumonia  in  small  animals,  the 
fibrous  tissue  production  follows  the  course  of  the  bronchi 
and  bronchioli.  The  lung  is  greatly  increased  in  weight,  has 
lost  its  spongy  condition,  and  is  quite  hard.  On  cut  surface 
it  shows  grayish-white  color,  and  sometimes  caseous  nodules 
of  necrosis  may  be  seen.  In  advanced  cases  the  pleura  is 
thickened  and  the  lungs  distorted.  The  two  layers  of  .the  pleura 
are  often  adherent  and  the  mediastinum  may  be  indurated. 

Symptoms.— Moderate  dyspnea  and  a  chronic  cough,  with 
a  discharge  which  may  be  slight  or  profuse,  and  the  exhaled 
air  has  a  fetid  odor  due  to  the  retention  of  some  of  the  dis- 
charge in  the  bronchiectatic  cavities.  The  temperature  is 
usually  normal  and  no  general  symptoms  are  noticed. 

Auscultation  reveals  increased  resonance  and  bronchial 
breathing.  Percussion  yields  dulness  except  where  there  are 
saccular  dilatations  of  the  bronchi. 

Diagnosis.— The  history  of  the  case  and  slow  development 
following  bronchopneumonia  and  the  presence  of  severe 
dyspnea  will  materially  aid  in  making  the  diagnosis. 

Prognosis.— Incurable. 

Treatment.— Expectorants  and  general  stimulants  may  be 
used  to  modify  the  symptoms. 

FOREIGN  BODY  PNEUMONIA. 

Gangrene  of  the  Lungs. 

Definition.— An  inflammation  of  the  lungs  due  to  the  inhala- 
tion of  coarse  material  which  usually  results  in  necrosis  of  a 
part  or  of  the  entire  organ. 

Etiology .  — (a)  Inhalation  of  foreign  material  (particles 
of  food  from  the  mouth,  especially  during  anesthesia  when 
vomition  occurs,  also  when  the  pharynx  and  larynx  are  par- 


FOREIGN  BODY  PNEUMONIA  59 

alyzed) ;  injury  to  the  lungs  from  contusions,  fractured  ribs, 
penetrating  wounds  through  the  thoracic  walls  or  from  the 
esophagus  and  stomach  (swallowed  needles,  sharp  pieces  of 
bone,  etc.). 

(6)  Inhalation  of  irritant  medicinal  substances  when 
improperly  administered  (by  closing  the  nasal  openings, 
pulling  the  tongue  forward  or  holding  the  mouth  open  too 
wide;  holding  the  head  too  high  or  in  any  position  which 
interferes  with  swallowing,  manipulating  the  larynx  or 
pharynx). 

(c)  The  causes  enumerated  above  are  to  be  considered  as 
predisposing  factors,  inasmuch  as  infection  must  be  present  to 
complete  the  process.  In  addition  to  the  ordinary  infection, 
which  is  normally  present  in  the  lungs,  putrefactive  organ- 
isms are  necessary  to  produce  gangrene. 

Pathology.— The  involvement  may  be  either  diffuse  or 
circumscribed,  usually  the  latter,  and  in  the  form  of  irregular 
areas  having  a  brown,  greenish  or  black  color.  These  are 
dry  and  surrounded  by  a  zone  of  congestion  and  around  this 
a  zone  of  edema.  The  gangrene  is  of  the  moist  variety  and 
gives  off  a  very  penetrating  odor.  Cavities  may  occur  in  the 
lungs  when  the  necrotic  material  is  coughed  out. 

Symptoms.— Dyspnea  is  pronounced  and  the  expired  air 
has  a  sweet,  fetid  odor.  The  temperature  is  elevated  (104°- 
106°  F.)  and  the  pulse  is  small,  rapid  and  very  irregular. 
In  the  early  stages  the  symptoms  are  similar  to  broncho- 
pneumonia,  but  when  cavities  appear  in  the  lungs  the  symp- 
toms rapidly  increase  in  severity.  It  is  at  this  stage  when 
the  odor  is  a  prominent  symptom. 

Diagnosis.— This  rests  upon  the  characteristic  odor  of  the 
exhaled  air,  high  temperature  and  the  rapid  development.  The 
history  of  the  case  often  assists  materially  in  the  diagnosis. 

Prognosis.— Very  unfavorable.  Most  cases  terminate  fatally 
in  a  few  days. 

Treatment.— The  animal's  strength  should  be  maintained 
by  the  use  of  highly  concentrated  foods  (raw  eggs,  extract  of 
beef,  milk,  etc.),  given  at  frequent  intervals. 

Little  can  be  expected  of  medical  treatment.  Inhalations 
(oil  of  tar,  turpentine,  or  creolin)  may  be  used  to  overcome 
the  odor  and  produce  antiseptic  action. 


CHAPTER  V. 
DISEASES  OF  THE  PLEURA. 

PLEURITIS.     PLEURISY. 

Definition.— An  inflammation  of  the  pleura  accompanied 
by  a  serous,  serofibrinous,  hemorrhagic,  or  purulent  exuda- 
tion into  the  pleural  cavity. 

Etiology .  — (a)  Penetrating  wounds  through  the  thoracic 
walls,  from  fractured  ribs  or  sharp  foreign  bodies  in  the  esoph- 
agus or  stomach;  contusion  of  the  thoracic  walls;  tumors 
in  adjacent  parts;  in  rare  cases  cysts  of  tapeworms.  These 
conditions  make  possible  the  entrance  of  organisms  directly 
into  the  pleura,  or  by  lowering  the  resistance  of  the  pleura 
wrhich  favors  the  growth  of  organisms  that  are  carried  to  it 
by  the  lymph  and  blood  streams.  These  are  quite  numerous 
and  consist  most  often  of  the  following:  Bacillus  bipolaris, 
Staphylococcus  pyogenes,  Leptothrix  buccalis,  and  Strepto- 
thrix  canis. 

(6)  Occurs  in  cases  of  nephritis  from  an  accumulation  of 
waste  products  in  the  blood  or  by  bacterial  toxins  which  are 
carried  to  the  pleura  by  the  blood  and  produce  direct  irrita- 
tion to  the  serous  membrane. 

(c)  Exposure  to  cold  and  cold  dampness  are  common 
predisposing  factors  as  they  reduce  the  general  resistance  to 
infection. 

(d)  Pleuritis  frequently  follows  bronchitis  and  pneumonia, 
the  organisms  present  enter  the  lymph  and  blood  streams  and 
are  carried  to  the  pleural  cavity.    In  some  cases  of  pneumonia 
where  abscesses  develop  and  open*  into  the  pleural  cavity  a 
purulent  pleuritis  is  produced. 

(e)  Extension  of  inflammation  of  neighboring  tissues,  viz: 
Mediastinitis  during  the  course  of  infectious  diseases;  acute 
peritonitis;  inflammation  of  abdominal  organs. 


PLEURITIS— PLEURISY  61 

(/)  Pleuritis  is  very  often  found  during  the  course  of  infec- 
tious diseases.  In  the  dog  it  occurs  frequently  as  a  secondary 
disease  following  distemper,  septicemia  and  pyemia,  the 
infection  being  carried  by  the  blood  and  lymph.  It  is  also 
seen  during  the  course  of  rheumatic  conditions. 

(g)  Other  predisposing  causes  are  extreme  exertion  (hunt- 
ing dogs,  greyhounds),  or  living  under  adverse  conditions 
(bench  shows,  during  transportation,  etc.)  which  reduce  the 
natural  resistance. 

Pathology.— The  involvement  in  pleuritis  may  be  acute 
or  chronic,  local  or  general,  and  according  to  the  variety  of 
exudate,  serous,  serofibrinous,  hemorrhagic  or  purulent.  A 
single  case  of  pleuritis  may  pass  through  all  of  the  above 
stages.  In  all  cases  the  pleura  becomes  hyperemic,  rough 
and  dull.  The  roughness  interferes  with  the  free  movement 
of  the  gliding  surface  producing  pain  and  the  characteristic 
frictional  sounds.  Later  exudation  takes  place  into  the 
pleural  cavity.  In  the  fibrinous  form  there  is  soon  an  exudate 
of  fibrin,  forming  a  thin,  yellowish  layer  on  the  surface,  and 
as  this  increases  it  causes  the  pleural  surfaces  to  adhere 
together  slightly.  The  exudate  is  composed  of  flakes  and 
masses  of  fibrin  containing  leukocytes.  The  exudate  may 
be  absorbed  completely,  but  if  there  has  been  much  fibrin 
formation  adhesions  of  varying  density  result.  These 
adhesions  later  are  organized  into  connective  tissue  which  is 
at  first  delicate  but  soon  becomes  very  dense,  and  in  some 
cases  so  extensive  as  to  obliterate  almost  completely  the 
pleural  cavity;  or  they  may  be  in  scattered  areas  only. 

In  serofibrinous  pleuritis  there  is  a  large  amount  of  serous 
as  well  as  fibrinous  exudate.  It  may  originate  as  the  fibrinous 
form,  but  usually  begins  with  a  serous  outpouring.  This 
exudate  is  denser  than  the  transudate  seen  in  hydrothorax, 
and  contains  the  usual  inflammatory  products.  The  amount 
of  fluid  will  vary  with  individual  cases  and  in  the  different 
small  animals  from  100  c.c.  to  5000  c.c.  When  present 
in  large  quantities  the  lung  is  pushed  backward  and  the 
neighboring  organs  pressed  upon.  This  pressure  on  the 
lungs  of  the  dog  and  cat  is  often  sufficient  to  completely 
occlude  the  passage  of  air  into  the  right  posterior  lobes. 


62  DISEASES  OF  THE  PLEURA 

Hemorrhagic  pleuritis  is  generally  the  result  of  infectious 
diseases  and  malignant  growths  on  the  pleura.  The  exudate 
is  chiefly  serous,  with  red  blood  cells  present,  but  at  times 
may  be  almost  pure  blood. 

Purulent  pleuritis  (pleuritis  purulenta;  pyothorax;  em- 
pyema)  is  the  result  of  infection  by  some  one  of  the  many 
pyogenic  organisms  (staphylococcus,  etc.).  It  may  begin 
as  a  purulent  pleuritis  or  it  may  follow  infection  of  the  sero- 
fibrinous  form.  In  the  pleural  cavity  is  found  a  varying 
amount  of  cloudy  fluid  which  contains  a  great  number  of  pus 
cells.  It  may  be  greenish  in  color  at  times,  but  is  usually 
yellowish.  The  pleurae  are  generally  thickened  and  con- 
gested and  covered  with  flakes  of  fibrin  or  degenerated 
endothelium.  The  pus  may  be  completely  absorbed  and  the 
two  surfaces  unite  with  dense  adhesions;  or  it  may  become 
caseated  and  undergo  calcareous  infiltration.  The  changes 
are  most  marked  in  the  visceral  pleura,  which  becomes 
greatly  thickened,  at  first  being  soft  and  edematous  while 
fluid  is  present,  but  as  .this  disappears  it  becomes  indurated. 
During  the  course  of  purulent  pleuritis  there  is  always  more 
or  less  involvement  of  the  lungs  which  in  some  cases  may 
result  in  pleurogenic  pneumonia.  In  some  chronic  cases  of 
pleuritis  (pleuritis  granulosa)  there  are  numerous  papilloma- 
like  enlargements  distributed  over  the  surface  of  the  pleura, 
and  these  by  becoming  confluent  may  produce  extensive 
masses  which  interfere  with  the  function  of  the  neighboring 
tissues  and  organs. 

The  serous  exudate  contains  endothelial  cells,  white  cor- 
puscles and  small  particles  of  fibrin.  The  infected  exudate 
contains  numerous  pus  cells,  endothelial  cells,  and  various 
kinds  of  detritis.  A  rather  high  percentage  of  albumin  is 
found  in  the  serous  exudate. 

Symptoms.— In  the  early  stages  of  pleuritis  the  symptoms 
manifest  themselves  in  various  ways,  depending  largely 
whether  the  disease  is  primary  or  secondary,  local  or  general. 
In  acute,  primary  pleuritis  the  disease  usually  begins  abruptly 
with  pronounced  general  symptoms,  viz:  A  chill,  the  animal 
seeking  a  warm  place,  twitching  and  trembling  of  the  muscles, 
followed  in  a  few  hours  with  an  elevation  of  temperature 


PLEUR1TIS— PLEURISY  63 

(103°-105°  F.)  and  a  small,  weak  and  thready  pulse.  Cough 
appears  early,  is  usually  dry,  and  on  account  of  the  pain,  is 
partially  suppressed.  The  gait  is  stiff  and  they  show  con- 
siderable pain  when  moved.  There  is  little  or  no  appetite, 
but  as  a  rule  the  thirst  is  intense.  The  visible  mucous  mem- 
branes are  reddened  and  congested,  and  in  cases  where  there 
is  much  exudation  the  membranes  are  cyanotic.  Constipa- 
tion is  often  noted,  the  feces  being  quite  dry  and  hard.  The 
urine,  while  the  exudate  is  forming,  is  voided  in  small  quanti- 
ties and  contains  albumin.  Later  as  it  is  absorbed  the  urine 
is  increased  in  amount  and  of  very  light  color. 

Dyspnea  is  quite  marked  in  nearly  all  cases  of  pleuritis. 
In  the  early  stages  when  the  pleura  is  dry,-  the  respirations 
are  superficial,  rapid  and  painful,  but  after  exudation  takes 
place  they  are  less  painful  but  labored.  When  bilateral  the 
animal  usually 'assumes  a  sitting  posture,  but  when  only  one 
side  is  affected,  will  lie  on  the  affected  side.  These  positions 
are  assumed  to  assist  in  fixing  the  intercostal  muscles  to 
relieve  the  pain  which  accompanies  the  elevation  and  depres- 
sion of  the  ribs.  The  abdominal  type  of  respiration  is  used, 
the  elbows  being  held  outwardly  and  the  abdominal  muscles 
and  the  diaphragm  brought  into  action.  There  is  less  ex- 
pansion on  the  affected  side  on  account  of  the  pain;  when 
both  sides  are  affected  the  ribs  are  held  in  a  fixed  position. 
Palpation  of  affected  parts  produces  acute  pain. 

Percussion.  Dulness  which  gradually  rises  as  the  fluid 
accumulates  in  the  cavity.  The  upper  line  of  dulness  is 
horizontal  and  varies  with  the  position  of  the  animal.  Above 
the  level  of  the  accumulated  fluid  tympany  will  be  noted. 

Auscultation.  In  the  early  stages  when  the  inflamed  mem- 
brane is  dry,  frictional  sounds  are  characteristic  and  the 
vesicular  murmur  is  increased,  but  as  the  exudate  collects 
the  sounds  become  less  distinct  or  blowing  in  character,  and 
finally  only  the  bronchial  tones  will  be  audible. 

In  the  chronic  form  all  the  acute  symptoms  are  modified 
with  slight,  if  any  general  disturbance,  although  the  tempera- 
ture may  be  variable,  changing  daily  from  below  to  above 
normal  (100°-103°  F.). 

Auscultation  gives  negative  results.  Pleuritic  adhesions 
cannot  be  diagnosed  during  life. 


64  DISEASES  OF  THE  PLEURA 

Diagnosis. —The  diagnosis  depends  upon  the  painful 
respiration,  pain  on  palpation,  abdominal  type  of  respiration, 
and  the  presence  of  fluid  in  the  thoracic  cavity.  History  of 
injury  may  also  aid  materially. 

Prognosis.— Usually  favorable  in  mild,  acute  cases  or  when 
local;  the  generalized  purulent  forms  rarely  recover. 

Treatment.—  Hygienic.— It  is  necessary  that  the  animal  be 
kept  in  a  warm  and  well  ventilated  place  but  free  from 
draughts  of  cold,  moist  air. 

Dietetic.— Concentrated  food  should  be  given  3  or  4  times 
daily,  using  warm  milk,  eggs  or  extract  of  beef. 

Medical.— In  the  very  early  stages  of  pleuritis  when  the 
frictional  sounds  are  present,  cold  applications  to  the  walls 
of  the  thorax  are  indicated  (cold  water  compresses,  ice  packs, 
etc.).  The  refrigeration  from  these  cold  applications  pene- 
trates the  walls  and  contracts  the  vessels,  thus  relieving  the 
congestion  of  the  pleura.  Later  (two  or  three  days)  warm, 
moist  compresses  are  indicated  to  increase  the  circulation 
which  will  modify  the  inflammatory  process  and  hasten  the 
absorption  of  the  fluid.  In  addition  to  this,  counterirritants 
(oil  of  mustard  and  alcohol  1-20,  tincture  of  cantharides, 
etc.)  could  be  used  to  continue  the  same  process.  When  the 
cough  is  severe,  narcotic  agents  (morphin  sulphate  0.025 
daily)  can  be  used  to  allay  the  irritation.  Quinin  sulphate 
(0.2  three  times  daily)  may  be  used  to  control  the  tempera- 
ture and  pulse  if  they  become  too  high.  Encourage  diuresis 
by  using  fluidextract  of  digitalis  (0.1-0.2  daily)  or  diuretin 
(0.2-0.5  three  times  daily).  If  constipation  be  present 
catharsis  may  be  produced  by  the  use  of  calomel  (0.05-0.5 
daily)  or  magnesium  sulphate  (5.0-10.0)  to  produce  a  hydra- 
gogue  action.  When  fluid  is  present  absorption  may  be 
induced  by  the  use  of  potassium  iodid  (0.2-0.3  three  times 
daily)  or  pilocarpin  (0.005-0.1)  except  in  cases  of  feeble 
heart  action  when  they  must  be  used  sparingly. 

Surgical.— The  effusion  will  require  aspiration  under  the 
following  conditions:  (a)  When  it  excites  much  dyspnea; 
(6)  when  in  large  quantities;  (c)  when  purulent;  (d)  when  it 
remains  unabsorbed  after  ten  to  twenty  days'  treatment. 

Thoracentesis  is  performed  by  the  use  of  a  thoroughly 


HYDROTHORAX  65 

sterilized  trocar  and  cannula  or  aspirating  needle.  It  is  best 
done  with  the  animal  in  either  a  sitting  or  standing  position. 
Remove  the  hair  from  and  disinfect  a  small  area  on  the  side 
of  the  thorax  so  that  the  instrument  may  be  inserted  (in  a 
forward  direction)  at  the  anterior  border  of  the  sixth,  seventh 
and  eighth  ribs  and  as  low  in  the  cavity  as  possible.  The 
cavity  is  reached  as  soon  as  resistance  to  the  passage  of  the 
needle  has  ceased.  The  fluid  flows  out  in  a  continuous  stream 
at  first,  then  synchronous  with  respiration.  After  some  of  the 
fluid  is  out,  the  air  may  rush  in  during  inspiration,  and  to 
prevent  this  hold  the  finger  over  the  tube  at  the  end  of  each 
expiration.  If  the  flow  ceases  suddenly  it  is  due  to  plugging 
with  flakes  of  fibrin  which  can  be  forced  away  by  reinsertion 
of  the  trocar.  The  amount  of  fluid  removed  depends  upon 
the  heart  action.  When  it  becomes  weak  and  rapid,  or  when 
coughing  suddenly  develops,  the  operation  should  be  dis- 
continued. This  can  be  done  daily  at  a  different  site  of 
puncture  until  all  of  the  fluid  is  removed. 


HYDROTHORAX. 

Definition.— A  collection  of  serous  fluid  in  the  thoracic 
cavity  without  inflammation  of  the  pleura. 

Etiology.— This  condition  always  occurs  as  a  secondary 
process  and  is  a  symptom  of  many  affections  (insufficiency  of 
the  heart ;  nephritis ;  chronic  diseases  of  the  lungs) .  It  usually 
accompanies  ascites,  hydropericardium  and  edema  of  the 
skin;  also  due  to  obstruction  of  vessels  (vena  azygos) ;  follows 
a  general  anemia,  hydremia,  chronic  infectious  diseases, 
carcinomas  and  sarcomas.  These  latter  diseases  damage 
the  endothelium  of  the  vessels  and  allow  the  transudation 
of  fluid  from  them. 

Pathology.— The  transudate  is  light  or  reddish-yellow  in 
color  and  contains  a  few  flakes  of  fibrin.  If  the  condition 
develops  very  rapidly,  the  transudate  contains  many  rod 
corpuscles.  The  specific  gravity  and  albumin  content  are 
less  than  that  of  blood  serum.  The  pleura  may  be  thickened 
and  pale. 
5 


66  DISEASES  OF   THE  PLEURA 

Symptoms.— Hydrothorax  develops  rapidly  and  on  both 
sides  of  the  thoracic  cavity.  Dyspnea  results  from  compres- 
sion of  the  lungs.  In  severe  cases  this  compression  may  be 
sufficient  to  cause  edema  of  the  lungs.  The  temperature  is 
normal.  The  shape  of  the  chest  is  unchanged  except  when  a 
very  large  quantity  of  fluid  is  present  causing  the  lower  part 
of  the  thorax  to  be  depressed. 

Auscultation  reveals  hard  respiratory  sounds  due  to 
increased  respiration.  Percussion  over  the  lower  part  of  the 
chest  reveals  dulness,  the  upper  level  of  which  changes  with 
the  position  of  the  animal.  Above  this  level  tympany  is 
pronounced. 

Diagnosis.— Dyspnea  with  sudden  onset  in  the  absence  of 
other  symptoms;  percussion,  and  exploratory  puncture. 

Prognosis.— Depends  upon  the  causative  disease. 

Treatment.— Medical.— Saline  purgatives  (magnesium  sul- 
phate, 8.0-12.0)  may  assist  in  the  removal  of  the  fluid  by 
eliminating  fluid  from  the  circulation. 

Surgical.— Thoracentesis  (see  pleuritis),  when  respiration 
becomes  distressed,  and  cyanosis  is  evident.  Repeat  as 
often  as  necessary,  using  a  new  site  for  puncture  each  time. 
Further  treatment  is  to  be  directed  to  the  primary  cause. 


PNEUMOTHORAX. 

Definition.— Air  in  the  pleural  sac. 

Etiology.— Mechanical.— Perforating  wounds  from  the 
exterior  (injuries,  exploratory  puncture,  etc.);  perforation 
through  the  diaphragm  by  abscesses  of  the  liver,  stomach 
or  esophagus;  perforation  from  the  lung  by  abscesses  or  rup- 
ture of  air  vessels  in  the  normal  lung.  Gas-producing  organ- 
isms (B.  aerogenes  capsulatus)  in  the  pleural  exudates  are 
occasional  causes. 

Pathology.— Pneumothorax  rarely  occurs  by  itself,  usually 
being  associated  with  serofibrinous  (hydropneumothorax) 
or  infectious  pleuritis  (pyopneumothorax),  due  to  infection 
being  carried  in  with  the  air.  A  serous  or  purulent  fluid  is 
found  in  the  pleural  sacs  and  the  membranes  are  inflamed. 


HEMOTHORAX  67 

Symptoms.— Dyspnea  is  usually  quite  pronounced,  the 
mucous  membrane  cyanotic  and  the  pulse  rapid  and  feeble. 
The  physical  signs  are  very  distinctive.  The  affected  side 
shows  marked  enlargement  and  the  heart  beat  is  displaced. 

On  percussion  the  resonance  is  usually  tympanitic,  and 
depending  upon  the  degree  of  tension  there  may  be  flat 
tympany,  or  a  full  hyperresonant  tone  like  emphysema, 
while  in  others  with  extreme  tension  dulness  will  be  noticed. 
There  is  usually  dulness  at  the  lower  part  due  to  the  effused 
fluid,  wrhich  can  readily  be  made  to  change  the  level  by 
changing  the  position  of  the  animal. 

On  auscultation  the  normal  lung  sounds  are  suppressed 
on  the  affected  side  and  exaggerated  on  the  other  side,  which 
is  very  suggestive.  The  rales  have  a  peculiar  metallic 
sound. 

Diagnosis.— The  dyspnea,  enlargement  of  the  affected  side, 
small  amount  of  effusion  in  the  cavity  and  cyanotic  mem- 
branes. 

Prognosis.— Depends  upon  the  cause  but  is  usually  favor- 
able. 

Treatment.— In  pneumothorax  with  extreme  tension  imme- 
diate aspiration  (see  thoracentesis)  should  be  performed. 
Penetrating  wounds  through  the  thoracic  walls  should  be 
occluded  (adhesive  plasters,  bandage,  etc.)  to  prevent 
further  entrance  of  air  and  infection  into  the  cavity.  A  small 
amount  of  it  will  be  readily  absorbed  and  if  infection  has  not 
been  carried  into  the  cavity  recovery  will  be  prompt. 


HEMOTHORAX. 

Definition.— An  effusion  of  pure  blood  into  the  pleural  sac. 

Etiology.— Traumatism,  rupture  of  the  vessels  from  over- 
exertion  especially  when  the  walls  of  the  vessels  are  diseased 
(carcinomas,  sarcomas,  and  infections). 

Pathology.— Presence  of  pure  blood  in  the  thoracic  cavity 
and  the  injury  to  the  vessel  wall. 

Symptoms.— The  symptoms  are  those  of  an  acute  anemia 
accompanied  by  a  rapid  filling  of  the  thoracic  cavity. 


68  DISEASES  OF  THE  PLEURA 

Diagnosis.— The  above  symptoms  in  addition  to  thoracen- 
tesis  confirm  the  diagnosis. 

Prognosis.— Depends  upon  the  extent  and  nature  of  the 
injury. 

Treatment.— Medical.— The  administration  of  internal 
astringents  (ergot  fld.  ext.  2.0-4.0)  or  adrenalin  chlorid 
(0.6-4.0  of  1-1000  sol.).  These  can  be  repeated  in  one  or 
two  hours  if  necessary.  Intravenous  injections  of  normal  salt 
solution  to  maintain  the  blood  pressure  may  also  be  used. 


PART  II. 
DISEASES  OF  THE  CIRCULATORY  SYSTEM. 

CHAPTER  I. 
DISEASES  OF  THE  PERICARDIUM. 

Examination.— An  examination  of  the  circulatory  system 
in  small  animals  is  of  importance  in  determining  diseases 
affecting  primarily  the  heart  and  bloodvessels,  and  also  for 
assisting  in  the  diagnosis  of  a  number  of  acute  infectious  and 
non-infectious  diseases. 

A  systematic  examination  from  a  clinical  standpoint 
includes  the  following:  (1)  The  pulse,  and  (2)  the  heart. 

1 .  The  pulse  is  best  examined  in  the  dog  by  slightly  press- 
ing the  femoral  artery  with  the  index  finger,  or  the  radial 
artery  inside  the  forearm.  In  small  dogs  this  is  often  diffi- 
cult, and  in  such  cases  the  hand  should  be  placed  against  the 
thorax  on  the  left  side  just  behind  the  elbow,  and  at  the 
lower  third  of  the  cavity,  where  the  heart  beat  is  readily 
distinguished.  In  cats  and  rabbits  this  method  is  the  most 
satisfactory.  In  birds  the  pulse  is  difficult  to  recognize  owing 
to  the  vessels  being  well  protected  and  the  heart  very  small 
and  surrounded  with  fat  and  the  other  organs.  A  phonendo- 
scope  is  best  used  to  detect  the  heart  beats.  Clinically  we 
must  consider:  (a)  The  frequency,  (6)  the  rhythm  or  cadence, 
and  (c)  the  quality  of  the  pulse. 

(a)  The  frequency  of  the  pulse  varies  considerably  in 
different  species  of  small  animals  and  birds,  and  also  in 
individual  animals  of  the  same  species.*  The  size,  age,  sex, 
breeding,  temperature,  time  of  day,  etc.,  all  have  a  decided 


70  DISEASES  OF  THE  PERICARDIUM 

influence  upon  it.    The  average  frequency  for  small  animals 
is  as  follows : 

Dogs 60-200 

Cats .  100-180 

Rabbits .  110-140 

Birds 120-180 

An  abnormal  increase  in  the  pulse  is  found  in  all  elevations 
of  temperature,  in  severe  injuries  (fractures  of  bones,  etc.), 
in  mental  excitement,  valvular  defects,  severe  hemorrhage, 
and  in  heart  weakness  from  any  cause. 

A  decrease  in  frequency,  or  slow  pulse,  occurs  in  the  later 
stages  of  some  poisonings,  diseases  of  the  brain  (chronic 
and  subacute  hydrocephalus),  tumors  in  the  brain,  icterus 
gravis,  collapse,  etc. 

(6)  The  rhythm  of  the  pulse  should  be  regular,  especially 
in  cats,  rabbits  and  birds;  in  the  dog  an  irregular  pulse  is 
found  so  frequently  in  apparently  healthy  animals,  that  it 
should  not  be  looked  upon  as  an  abnormal  condition ;  in  fact, 
an  irregular  pulse  in  the  dog  is  the  rule.  An  irregular  or 
arhythmic  pulse  is  therefore  a  physiological  condition  in  some 
of  the  small  animals.  However,  in  many  pathological  con- 
ditions a  pronounced  irregularity  occurs  as,  during  convales- 
cence from  infectious  diseases,  severe  gastro-intestinal  dis- 
turbances, severe  weakness,  and  in  some  chronic  constitu- 
tional diseases.  An  irregular  pulse  is  observed  often  after 
large  doses  of  digitalis. 

(c)  The  quality  of  the  pulse.  The  pulse  beat  should  be 
of  equal  volume,  and  it  varies  with  the  different  species  of 
animal.  In  all  small  animals  the  pulse  is  rapid,  strong  and 
hard.  In  the  dog  an  unequal  pulse  is  frequently  observed. 
The  pulse  is  full  and  distended  after  exercise,  during  the  early 
stages  of  a  number  of  diseases;  empty  after  severe  hemor- 
rhage, intense  heart  weakness  and  collapse.  The  pulse  is 
hard  and  full  in  severe  pain,  peritonitis,  and  acute  brain 
diseases. 

The  venous  pulse  is  often  observed  in  old  dogs  and  is 
usually  indicative  of  some  chronic  heart  affection,  or  general 
heart  weakness. 


EXAMINATION  71 

2.  The  Heart.— This  is  best  examined  in  small  animals,  by 
(a)  palpation,  (6)  percussion,  and  (c)  auscultation. 

(a)  Palpation.  The  heart  beat  is  readily  felt  in  all  small 
animals  by  placing  the  hand  over  the  cardiac  region  (between 
the  fourth  and  seventh  ribs,  lower  third  of  thorax  on  either 
side).  The  heart  beat  can  be  felt  on  both  sides  of  the  chest. 
This  method  of  determining  the  frequency  of  the  heart  beat 
is  practical  especially  in  very  young  or  small  animals,  and, 
as  noted,  also  gives  us  the  frequency  of  the  pulse. 

The  force  of  the  heart  beat  depends  largely  upon  the  con- 
dition of  the  animal  (emaciated  or  fat),  and  whether  taken 
during  exercise,  excitement  or  at  rest. 

The  force  of  the  heart  beat  is  increased  in  the  following 
conditions: 

In  hypertrophy  of  the  heart,  acute  myocarditis,  endo- 
carditis, and  pericarditis;  some  poisons,  such  as  aconite  and 
digitalis;  after  severe  exertion  or  excitement;  after  consider- 
able loss  of  blood;  where  the  temperature  is  elevated.  The 
heart  beat  is  weakened  in  the  following:  Degeneration  of  the 
heart  muscle;  the  later  stages  of  acute  infectious  diseases; 
some  poisonings;  compression  of  the  heart  in  hydrothorax, 
hydropericardium,  pneumopericardium;  emphysema  of  the 
lungs,  and  in  the  effusion  stage  of  pleuritis.  In  unilateral 
pleuritis  the  normal  force  of  the  beat  may  be  more  plainly 
noted  on  the  healthy  than  on  the  diseased  side. 

(6)  Percussion.  This  is  of  little  value  in  diagnosis  in 
small  animals.  The  zone  of  cardiac  dulness  is  between  the 
fourth  and  seventh  ribs.  This  zone  is  normally  about  two 
to  two  and  one-half  inches  in  diameter. 

The  zone  of  cardiac  dulness  is  increased  in  hypertrophy 
of  the  heart;  hydropericardium;  tumors  and  induration  of 
the  lungs  (chronic  interstitial  pneumonia).  The  zone  is 
decreased  in  emphysema  of  the  lungs  and  pneumothorax. 
Pain  is  observed  on  percussion  in  acute  pericarditis  and  myo- 
carditis. 

(c)  Auscultation.  This  method  of  examination  is  of  great 
value  in  determining  the  condition  of  the  heart.  It  is  best 
done  in  the  small  animal  by  placing  the  patient  in  a  standing 
position  on  a  table,  covering  the  cardiac  region  with  a  cloth, 


72  DISEASES  OF  THE  PERICARDIUM 

and  placing  the  right  ear  directly  over  it.  A  phonendoscope 
may  be  used  which  materially  assists  in  differentiating  the 
heart  sounds,  the  instrument  greatly  intensifying  them. 
Normally,  there  are  two  heart  tones.  One  of  these  occurs 
at  the  moment  of  contraction  of  the  heart  (systolic),  and 
the  other  at  the  dilatation  of  the  organ  (diastolic).  In  most 
small  animals  the  rapid  pulse  makes  it  difficult  to  distin- 
guish between  these  sounds.  It  is  therefore  best  to  com- 
pare the  pulse  with  the  heart  beat.  The  interval  between 
the  systolic  and  diastolic  sounds  is  shorter  than  the  one 
between  the  diastolic  and  systolic.  In  very  fat  animals  it 
is  difficult  to  distinguish  the  heart  tones  with  any  degree  of 
accuracy.  In  rabbits  and  cats  the  heart  tones  are  often  so 
rapid,  the  sounds  following  each  other  in  such  rapid  succes- 
sion, that  they  are  indistinguishable.  This  condition  occurs 
in  all  animals  after  excitement  or  exercise.  In  very  young 
animals  it  is  normal.  In  birds  the  heart  sounds  are  almost 
impossible  to  recognize. 

Both  of  these  heart  sounds  are  increased  in  hypertrophy 
of  the  heart,  anemias,  and  thickening  of  the  lung  tissue 
around  the  heart. 

The  second  or  diastolic  sound  is  increased  in  distention 
of  the  arteries,  often  the  result  of  a  congestion  of  the  pulmo- 
nary circulation  combined  with  hypertrophy  of  the  heart. 

A  decrease  in  the  volume  of  the  heart  sounds  is  observed 
in  heart  weakness,  such  as  degeneration  of  the  heart  muscle, 
in  hydropericardium,  and  in  emphysema  of  the  lung.  In 
many  of  these  cases  the  heart  sounds  are  imperceptible.  In 
small  animals  the  various  heart  bruits  (abnormal  sounds) 
are  often  difficult  to  recognize. 

It  will  require  careful  and  persistent  effort  on  the  part  of 
the  student  to  familiarize  himself  with  even  the  more  common 
bruits  which  are  the  following:  (1)  Endocardial,  and  (2) 
pericardial. 

1.  Endocardial  Bruits  are  divided  into:  (a)  Organic 
endocardial  bruits  which  are  caused  either  by  a  narrowing 
(stenosis)  of  the  valves  of  the  heart,  or  changes  in  the  valves 
which  interfere  with  their  proper  closing  (insufficiency). 
(6)  Inorganic  endocardial  bruits  occurring  without  any 


PERICARDITIS  73 

particular  alteration  at  the  orifices  or  valves  of  the  heart, 
and  are  found  in  the  different  forms  of  anemia  in  animals. 

2.  Pericardia!  Bruits.— These  bruits  consist  of  friction 
sounds  due  to  the  pericardium  becoming  rough  and  dry. 
These  sounds  can  be  distinguished,  as  they  do  not  occur 
synchronously  with  the  heart  sounds  and  are  often  indepen- 
ent  of  them.  They  are  noted  in  pericarditis  where  there  is 
not  sufficient  fluid  to  keep  the  membranes  separated.  They 
must  be  distinguished  from  pleural  friction  sounds,  and  can 
be  quite  readily,  as  they  occur  entirely  independent  of  the 
respiratory  movements. 

From  a  clinical  standpoint,  in  small  animals,  further 
differentiation  of  the  various  heart  bruits  cannot  be  made. 

PERICARDITIS. 

Definition.— An  acute  or  chronic  inflammation  of  the  peri- 
cardium. 

Etiology.— Inflammation  of  the  pericardium  may  originate 
primarily  or  secondarily. 

Primary  pericarditis  may  result  from:  (a)  Trauma,  which 
may  originate  from  within,  such  as  the  passage  of  foreign 
bodies  (needles,  pins,  pieces  of  bone,  etc.)  through  the  esopha- 
geal  walls.  This  occurs  most  commonly  in  the  dog  and  cat 
from  swallowing  needles,  pins,  etc.,  during  play.  It  may  also 
result  from  trauma  from  without,  such  as  puncture  wounds 
through  the  thoracic  walls,  or  from  falling,  being  run  over 
by  vehicles,  etc.  In  such  cases  the  pericardium  is  injured 
directly  or  indirectly  by  being  pressed  upon  by  the  displaced 
thoracic  wall  or  adjacent  organs. 

(6)  Infective  processes  which  in  some  cases  may  be 
primary  or  at  least  involve  principally  the  pericardium. 
Staphylococci,  streptococci  and  the  specific  virus  of  dis- 
temper are  the  most  common  organisms  found.  Primary 
infection,  however,  is  not  a  common  etiological  factor. 

(c)  Cold  has  frequently  been  mentioned  as  one  of  the 
causes  of  pericarditis.  This  should  be  considered  simply 
as  a  predisposing  factor  in  lowering  general  resistance,  which 
allows  the  development  of  infection,  etc. 


74  DISEASES  OF  THE  PERICARDIUM 

Secondary  Pericarditis.— This  form  may  result  from  a 
number  of  conditions:  (a)  Catarrhal  pneumonia,  which  is 
common  in  the  dog  and  cat;  simple  pleuritis;  endocarditis, 
myocarditis,  etc.  It  may  also  follow  diseases  of  the  medi- 
astinal  lymph  glands,  the  ribs,  sternum,  and  even  in  some 
cases  the  abdominal  viscera.  (6)  In  septic  processes,  such 
as  suppurating  wounds,  puerperal  septicemia,  etc.  (c)  In 
specific  febrile  diseases,  such  as  distemper  in-  the  dog  and 
cat,  pneumonia,  chicken  cholera,  etc. 

Necropsy.— On  postmortem  are  recognized:  (a)  Acute 
fibrinous  pericarditis,  (6)  pericarditis  with  effusion,  and  (c) 
chronic  adhesive  pericarditis. 

(a)  Acute  Fibrinous  Pericarditis.— This  may  be  local  or 
general.  In  the  mild  form  dull,  rough,  lusterless  masses  of 
exudate  cover  the  surface  of  the  pericardium  with  a  thin 
coating  of  fibrin  which  is  readily  peeled  off.  In  the  more 
severe  form  the  exudate  is  more  abundant,  the  masses  of 
organized  fibrinous  deposits  giving  the  surface  a  rough, 
shaggy  appearance.  In  this  form  there  is  usually  found  a 
small  quantity  of  fluid  in  the  meshes  of  the  fibrin.  The  heart 
muscle  is  not  affected,  except  in  the  more  severe  form  where 
it  will  be  found  pale  and  turbid. 

(6)  Pericarditis  with  Effusion.— This  effusion  may.be  sero- 
fibrinous,  hemorrhagic  or  purulent.  It  is  most  commonly 
serofibrinous.  In  this  case  the  pericardial  surfaces  are  covered 
with  a  thick  fibrin  and  a  collection  of  serous  fluid  fills  the 
pericardial  sac.  The  hemorrhagic  form  is  usually  found  in 
acute  cases  which  have  terminated  fatally  following  injuries, 
etc.  The  pericardial  sac  will  contain  a  varying  quantity  of 
serous  fluid  mixed  with  blood.  When  pus  is  present  the  peri- 
cardial surfaces  will  appear  rough,  occasionally  eroded  and 
of  grayish  color.  This  form  occurs  via  metastasis  or  from 
internal  trauma  introducing  infection  into  the  pericardial  sac. 

(c)  Chronic  Adhesive  Pericarditis.— Chronic  adhesive  peri- 
carditis is  found  occasionally  on  postmortem.  It  is  char- 
acterized by  marked  thickening  of  the  membranes,  with 
adhesions  between  the  membranes  themselves,  and  the 
adjacent  organs. 


PERICARDITIS  75 

Symptoms.— Mild  cases  of  pericarditis  present,  as  a  rule, 
no  symptoms  by  which  an  accurate  diagnosis  can  be  made. 
In  the  more  severe  forms,  fever  is  usually  present,  but  the 
elevation  of  temperature  depends  as  much  upon  the  primary 
disease  as  upon  the  pericarditis  present.  Temperature  is 
usually  103°-104°  F.  The  respirations  are  increased,  espe- 
cially when  the  animal  is  moved,  the  slightest  exertion  causing 
a  marked  dyspnea.  Palpation  over  the  cardiac  region  often 
reveals  a  distinct  fremitus  from  the  pericardial  folds  rubbing 
together. 

Auscultation.  The  friction  sound  due  to  the  rubbing 
together  of  the  pericardial  surfaces  is  distinctly  audible,  and 
is  the  most  important  diagnostic  symptom.  The  examiner 
is  greatly  aided  by  the  phonendoscope,  which  brings  out  the 
friction  sounds  more  prominently  compensating  for  their 
indistinctness  due  to  the  rapid  heart  beat. 

As  the  disease  advances,  the  heart  action  becomes  inter- 
fered with,  and  all  the  symptoms  of  valvular  insufficiency 
will  present  themselves.  Dropsical  conditions  from  defective 
arterial  tension  will  be  in  evidence,  especially  ascites,  and 
dropsy  of  the  extremities.  There  are  general  symptoms  of 
impaired  appetite,  emaciation  and  general  weakness.  Death 
may  occur  suddenly  or  the  condition  become  chronic  and 
last  for  weeks,  depending  very  largely  upon  the  cause. 

Diagnosis.— An  accurate  diagnosis  in  small  animals  presents 
some  difficulties,  and  a  thorough  examination  is  always 
necessary.  The  frictional  tones  are  characteristic,  but  they 
are  determinable  only  in  the  acute  fibrinous  pericarditis. 

Prognosis.— In  the  milder  cases  of  acute  fibrinous  peri- 
carditis and  serofibrinous  pericarditis  the  prognosis  while 
favorable,  should  always  be  guarded  at  least  until  the 
etiological  factor  can  be  established.  Other  forms  are  always 
to  be  considered  unfavorable. 

Treatment.—  Hygienic.— The  animal  should  be  placed 
where  there  is  absolute  quiet.  Prevent  excitement,  such  as 
by  the  visits  of  the  owner,  or  strangers.  Have  the  room 
moderately  warm  and  well  ventilated. 

Dietetic.— Nutritious  food  (lean  meat,  raw  or  cooked ;  milk, 
etc.)  should  be  given  to  maintain  the  general  condition  of  the 
animal. 


76  DISEASES  OF   THE  PERICARDIUM 

Medical.— Heart  tonics  and  stimulants  are  indicated  to 
tone  up  the  action  of  the  heart,  and  to  assist  in  the  elimina- 
tion of  fluid  from  the  body.  Digitalis  is  of  value  for  this 
purpose,  given  to  dogs  in  doses  of  0.1-0.2  of  the  fluidextract 
once  or  twice  daily  depending  upon  the  condition  of  the 
patient. 

Laxatives  (magnesium  sulphate  8.0-12.0,  or  calomel  0.05- 
0.1)  are  indicated  occasionally  to  regulate  the  bowels  and 
also  to  assist  in  the  elimination  of  fluids. 

Surgical.— When  the  exudate  accumulates  to  the  extent 
of  greatly  interfering  with  the  heart  action,  indicated  by 
dyspnea,  small  rapid  pulse,  cyanosis,  etc.,  paracentesis  of  the 
pericardium  should  be  performed  at  once.  The  operation  is 
not  very  difficult  and  is  as  follows:  A  rather  long,  small 
exploring  trocar  or  aspirating  needle  is  thoroughly  sterilized. 
Shave  the  hair  over  the  left  cardiac  region,  wash  thoroughly 
with  soap  and  water,  and  follow  with  alcohol ;  then  paint  the 
surface  with  tincture  of  iodin.  The  needle  should  be  inserted 
at  the  lowest  point  in  the  pericardial  sac  so  as  to  be  able  to 
remove  all  the  exudate  and  lessen  the  danger  of  injury  to  the 
heart.  Insert  the  needle  slightly  downward  and  forward, 
and  not  too  deep.  The  fluid  will  flow  out  in  a  steady  stream. 
Repeated  operations  on  successive  days  are  often  necessary. 
The  skin  wound  should  be  protected  by  covering  with  flexible 
collodion. 

HYDROPERIC  ARDIUM . 

Dropsy  of  the  Pericardium. 

Definition. — A  collection  of  serous  fluid  (transudate)  in 
the  pericardial  sac  not  due  to  inflammation. 

Etiology.— This  condition  most  often  accompanies  general 
hydropsy  resulting  from  valvular  defects  (insufficiencies), 
myocarditis,  diseases  of  the  coronary  arteries,  chronic  nephri- 
tis, etc.  It  also  occurs  from  pericarditis  (see  Pericarditis). 

Symptoms.— The  symptoms  are  similar  to  pericarditis 
(see  Pericarditis)  except  it  runs  a  longer  and  more  chronic 
course.  There  is  absence  of  temperature,  and  frictional  bruit 
is  heard  on  auscultation. 

Treatment.— Same  as  for  serofibrinous  pericarditis,  which 
see. 


HEMOPER1CARDIUM  77 

HEMOPERICARDIUM. 

Definition.— A  collection  of  blood  in  the  pericardial  sac. 

Etiology.— This  condition  is  found  in  aneurysm  of  the 
aorta,  cardiac  wall,  or  coronary  arteries,  and  in  rupture  and 
wounds  of  the  heart.  Dogs  and  cats  are  frequently  affected 
from  gunshot  wounds,  being  run  over,  etc. 

Symptoms.— The  principal  symptoms  are  those  of  rapid 
heart  weakness,  paleness  of  the  mucous  membranes,  rapid 
weakness  and  in  most  cases  death  in  a  very  short  time  from 
compression  of  the  heart.  In  slight  hemorrhages  the  animal 
may  live  for  several  hours  or  days  with  a  progressive  heart 
weakness,  dyspnea  and  all  the  physical  signs  of  effusion  in 
the  pericardial  sac. 

Treatment. — Treatment  in  most  cases  is  impossible,  and  in 
the  slow  progressive  cases  usually  unsatisfactory. 

Other  diseases  of  the  pericardium,  such  as  pneumoperi- 
cardium,  are  of  no  importance  clinically. 


CHAPTER  II. 
DISEASES  OF  THE  HEART. 

VALVULAR  INSUFFICIENCY  AND  STENOSIS. 

Definition.— A  pathological  or  anatomical  defect  in  the 
valves  and  openings  of  he  heart  leading  to  an  irregularity 
in  the  circulation  of  the  blood.  These  conditions  are  very 
common  in  small  animals,  especially  the  dog,  where  often 
quite  extensive  alterations  in  the  valves  are  found  on  autopsy 
which  failed  to  produce  any  marked  symptom  during  life. 
However,  when  severe  forms  of  insufficiency  or  stenosis 
occur,  they  are  characterized  by  a  marked  disturbance  in  the 
heart  action,  circulation  of  the  blood  and  the  general  condi- 
tion of  the  animal.  It  is  often  very  difficult  and  sometimes 
impossible  to  differentiate  clinically  between  the  various 
valvular  and  ostial  defects  which  are  found  on  autopsies. 

Insufficiency.— In  general,  this  condition  occurs  in  two 
forms:  (a)  Imperfect  closing  of  the  valves  which  permits 
a  portion  of  the  blood  at  the  contraction  of  the  heart  muscle 
to  flow  back  into  the  chamber  from  which  it  came.  This 
defect  may  exist  in  the  atrioventricular  valves  or  in  the  semi- 
lunar.  Improper  closing  of  the  semilunar  valve  allows  a 
portion  of  the  blood  which  has  been  forced  into  the  artery 
to  again  return  to  the  chamber  during  diastole;  or  imperfect 
closing  of  the  mitral  or  tricuspid  valves  during  systole  allows 
a  portion  of  the  blood  to  flow  back  into  the  auricles  again 
from  whence  it  came.  In  the  early  stages  of  insufficiency, 
owing  to  certain  compensatory  processes,  no  marked  symp- 
toms will  be  observed.  However,  as  soon  as  the  heart  is  not 
capable  of  performing  the  increased  labor  from  lack  of  nutri- 
tion, increased  disturbance  in  the  valves,  or  general  weakness 
from  anemia,  cachexia,  etc.,  marked  disturbance  in  the 
general  circulation  will  soon  become  evident.  These  are 


VALVULAR  INSUFFICIENCY  AND  STENOSIS        79 

manifested  by  ascites,  dropsical  effusions,  etc.,  in  different 
parts  of  the  body. 

(6)  Stenosis  or  contraction  of  the  openings.  In  this  con- 
dition the  opening  is  narrowed  so  that  the  chambers  of  the 
heart  are  improperly  filled.  At  the  period  of  diastole,  the 
blood  is  held  back  at  the  entrance  of  the  affected  chamber, 
and  therefore  normal  filling  of  the  chamber  is  interfered 
with.  This  condition  may  occur  at  any  of  the  openings  of 
the  heart  and  will  always  induce  imperfect  heart  action. 
Every  interference  with  an  arterial  opening  causes  imperfect 
ventricular  contraction;  likewise  defective  venous  openings 
lessen  the  auricular  contraction  and  power.  This  abnor- 
mality in  the  action  of  the  heart  produces  more  or  less 
general  disturbance  in  the  circulation  of  the  blood,  and  as 
a  consequence  the  reserve  force  of  the  heart  is  called  into 
action  until  compensatory  hypertrophy  can  take  place  to 
keep  the  circulation  as  near  normal  as  possible.  As  soon  as 
the  reserve  energy  is  used,  or  the  compensatory  hypertrophy 
fails  to  keep  up  the  circulation,  serious  general  symptoms 
of  defective  circulation  appear  as  is  often  observed  in  old  dogs. 

Etiology.— Valvular  defects  are  produced  by  a  variety  of 
causes : 

(a)  Endocarditis  is  the  most  common  cause  (see  Etiology 
of  Endocarditis).  Endocarditis  produces  an  inflammatory 
thickening  of  the  margins  of  the  valves  leading  to  their 
imperfect  closure.  If  the  chronic  inflammations  persist  it 
leads  to  cicatricial  contractions  (stenoses),  and  often  there 
are  found  in  long  standing  cases  in  old  animals,  deposits  of 
calcareous  matter  on  the  valves  and  around  the  openings. 

(6)  Dilatation  of  the  heart  or  weakness  of  the  heart  muscle 
will  sometimes  affect  the  openings,  the  dilatation  preventing 
contact  of  the  valve  margins  and  a  complete  closure. 

(c)  Certain  poisons  and  toxins  are  causes  \vhich  lead  to 
alterations  in  the  structure  and  ultimately  the  action  of  the 
valves. 

(d)  Atheromatous  processes  may  produce  the  condition. 
However  this  is  not  common  in  small  animals. 

(e)  Occurs  during  the  course  of  some  diseases,  such  as 
anemia,  pernicious  anemia,  etc. 


80  DISEASES  OF  THE  HEART 

Necropsy.— It  has  been  found  that  the  mitral  and  aortic 
valves  are  the  ones  most  commonly  affected  in  the  dog.  In 
the  early  stages  the  edges  of  the  valves  are  slightly  thickened 
and  invaded  with  small  nodules.  Later  are  found,  as  the 
sclerotic  changes  increase,  contractions  of  the  fibrinous 
tissue,  producing  thickening  and  deformity  of  the  segments 
of  the  valves,  the  edges  of  which  become  round,  curled  and 
cannot  be  closed  perfectly.  In  some  severe  cases  the  valves 
become  very  much  thickened,  with  numerous  hard  nodules 
(which  may  be  calcareous),  giving  them  a  marked  uneven 
surface.  The  chordae  tendinese  are  often  found  thickened 
and  contracted.  The  apices  of  the  papillary  muscles  fre- 
quently show  fibrated  or  calcareous  change. 

Symptoms.— In  small  animals  the  general  symptoms  of 
valvular  deficiency  are  of  greatest  importance  from  a  clinical 
standpoint,  as  it  is  very  difficult  during  the  life  of  the  animal 
to  distinguish  with  any  degree  of  accuracy  the  separate 
valvular  insufficiencies.  However,  some  of  them  present 
some  symptoms  which  are  rather  characteristic,  and  there- 
fore, a  brief  description  of  the  most  common  ones  will  be 
given. 

As  general  symptoms,  the  following  are  the  principal  ones 
observed  which  are  common  to  all  valvular  defects  at  some 
period  in  their  course:  Increased  heart  action;  rapid  and 
irregular  pulse;  palpitation  of  the  heart;  venous  pulse 
(observed  in  the  jugular  at  its  entrance  to  the  thorax); 
dyspnea;  cyanosis  of  mucous  membranes;  hydrothorax; 
ascites;  edema  along  abdomen,  pectoral  region,  extremities; 
general  emaciation,  partial  or  complete  loss  of  appetite  with 
marked  digestive  disturbance.  The  condition  gradually 
becomes  aggravated  until  there  is  a  general  nutritive  dis- 
turbance, weakness,  and  death  from  exhaustion.  Careful 
auscultation  will  reveal  the  valvular  insufficiency.  Palpation 
over  the  cardiac  region  will  determine  the  irregular  and 
rapid  pulse,  and  often  a  distinct  fremitus.  The  temperature 
in  the  early  stages  is  usually  elevated  (103°-104°  F.);  it 
later  becomes  normal  or  even  subnormal  as  the  disease 
progresses. 

Symptoms  of  insufficiency  of  the  mitral  valves:  This  is  of 


VALVULAR  INSUFFICIENCY  AND  STENOSIS        81 

frequent  occurrence  in  the  dog.  It  is  often  accompanied  by 
dilatation  or  hypertrophy  of  the  heart.  Pulse  rapid  and 
irregular;  systolic  bruit  and  increase  of  the  diastolic  sound  on 
auscultation;  dyspnea;  cyanosis;  general  weakness;  dropsical 
conditions  (ascites,  etc.).  A  careful  examination  is  necessary 
to  make  a  differential  diagnosis. 

The  direct  effect  of  aortic  insufficiency  is  the'regurgitation 
of  blood  from  the  artery  into  the  ventricle,  causing  a  disten- 
tion  of  the  cavity  and  a  reduction  of  blood  pressure  in  the 
artery.  The  amount  returning  varies  with  the  size  of  the 
opening.  This  regurgitation  eventually  leads  to  dilatation 
and  finally  hypertrophy.  In  this  way  the  valve  defect  is 
compensated  for,  and  as  with  each  ventricular  contraction  a 
larger  amount  of  blood  is  forced  into  the  arterial  system,  the 
regurgitation  of  a  certain  amount  for  a  time  during  diastole 
does  not  interfere  with  the  nutrition  or  with  the  general 
circulation. 

The  condition  is  characterized  clinically  by:  A  full  pulse; 
strong  heart  beat;  dyspnea;  dropsical  conditions  (ascites, 
etc.) ;  cough  from  congestion  and  edema  of  the  lungs;  increased 
area  of  dulness  in  the  cardiac  region;  diastolic  bruit,  etc. 

Insufficiencies  of  other  valves  are  impossible  to  recognize 
during  life  in  these  animals. 

Diagnosis.— The  faulty  heart  action  is  not  difficult  to 
recognize,  but  to  determine  the  location  of  the  lesion  is  very 
difficult  in  small  animals.  In  some  cases,  however,  by  care- 
fully observing  the  symptoms  and  using  the  phonendoscope 
a  differentiation  is  possible. 

Prognosis.— Complete  recovery  cannot  be  expected  even 
in  mild  cases  of  insufficiency,  therefore  the  prognosis  is 
unfavorable.  However,  the  condition  may  exist  for  a  long 
time  in  individual  cases  without  producing  any  serious 
symptoms  provided  adequate  compensation  exists. 

Treatment.  — (a)  During  the  stage  of  compensation  no 
medical  treatment  is  indicated.  Keep  the  animal  quiet  as 
possible,  avoid  all  undue  excitement  and  exercise,  and  give 
nutritious  food  to  maintain  the  general  condition. 

(b)  Stage  of  broken  compensation,  when  the  symptoms 
of  weakness,  edema,  palpitation,  etc.,  appear,  heart  tonics 
6 


82 

are  indicated.  Digitalis  fluidextract  (0.05-0.15);  tinct. 
strophanthus  (0.5-1.5  twice  daily);  or  caff  em  citrate  (0.1-0.2 
twice  daily).  By  the  use  of  these  preparations  an  effort  is 
made  to  reestablish  a  compensatory  action,  and  should  this 
take  place  the  symptoms  of  edema,  ascites,  palpitation,  etc., 
will  gradually  disappear.'  Should  this  treatment  be  unsuc- 
cessful, a  symptomatic  treatment  may  be  tried  such  as  the 
use  of  diuretics  and  cathartics  to  relieve  the  effusions,  and 
in  severe  palpitation,  sedatives  (morphin).  In  cases  of 
severe  weakness,  where  the  pulse  is  very  weak  and  irregular, 
direct  heart  stimulants  (camphor,  ether,  etc.)  must  be  given 
to  afford  temporary  relief. 

In  disturbances  of  the  digestive  tract  with  loss  of  appetite, 
tincture  of  nux  vomica  (0.2-0.8)  or  tincture  of  gentian  (1.0- 
2.0)  should  be  given  twice  daily  to  tone  the  digestive  tract. 
Other  symptoms  that  develop  must  be  treated  according  to 
their  importance. 

MYOCARDITIS. 

The  following  forms  of  myocarditis  are  observed  in  small 
animals:  (a)  Acute  myocarditis,  and  (6)  chronic  myocarditis. 

Acute  Myocarditis.— Definition.— An  acute  inflammation 
of  the  heart  muscle  (myocardium).  From  a  pathological 
standpoint  two  distinct  types  of  this  condition  are  recog- 
nized, viz.:  The  acute  parenchymatous  and  the  purulent 
myocarditis.  From  a  clinical  standpoint  such  a  differentia- 
tion cannot  usually  be  made.  Therefore,  both  will  be  con- 
sidered under  acute  myocarditis. 

Etiology.— (a)  From  severe  exertion,  such  as  hunting  dogs 
on  long  runs,  continuous  stud  service,  hard  pulling  of  draft 
dogs,  etc. 

(6)  Exposure  to  cold,  or  sudden  chilling  of  the  surface  of 
the  body,  resulting  in  an  unequal  distribution  of  the  blood, 
producing  a  congestion  of  the  bloodvessels  of  the  heart  and 
occasionally  resulting  in  an  inflammatory  reaction. 

(c)  Secondary  to  infectious  diseases,  such  as  distemper, 
pyemia,  septicemia,  tuberculosis,  cholera,  and  entero- 
hepatitis  in  fowls,  etc.  During  the  course  of  the  infectious 
diseases  toxins  are  formed  and  carried  by  the  blood  to  the 


MYOCARDITIS  83 

heart  muscle  leading  to  inflammation  and  fatty  degeneration. 
The  other  organs  in  the  body  are  often  similarly  affected 
during  the  course  of  infectious  diseases. 

(d)  From  poisons  (arsenic,  phosphorous,  silver,  mercury, 
etc.)  being  absorbed,  carried  through  the  circulation  to  the 
heart  muscle,  producing  irritation,  congestion,  and  some  of 
them  (phosphorous,  arsenic)  later  fatty  degeneration  of  the 
muscle. 

(e)  Often  results  by  spread  of  the  inflammation  from  the 
endocardium  and  pericardium,  especially  in  ulcerous  endo- 
carditis and  suppurative  pericarditis,  the  infection  reaching 
via  blood  the  heart  muscle. 

(/)  Direct  injuries  to  the  heart  which  occur  quite  frequently 
in  small  animals  from  foreign  bodies  perforating  the  esoph- 
agus or  chest  wall;  also  by  being  run  over,  the  heart  muscle 
becoming  contused. 

Necropsy.— Pathologically  numerous  conditions  are  found, 
the  changes  in  the  myocardium  are  quite  varied,  and  in  acute 
myocarditis  may  be  classed  under  two  heads  as  follows: 

(a)  Acute  Parenchymatous  Myocarditis.— This  as  a  primary 
condition,  is  not  very  common,  and  is  usually  associated  with 
acute  inflammation  in  other  organs.  In  this  form  there  is 
found  interstitial  infiltration,  inflammation  of  the  muscle 
fibers,  which  are  colored  reddish-gray,  yellowish-white,  or 
even  white.  The  muscle  fibers  are  indistinct  and  show  a 
more  or  less  homogeneous  structure. 

Microscopically,  the  fibers  show  a  loss  of  striation,  with 
small  cellular  infiltration  in  the  interstitial  connective  tissue. 
Large  numbers  of  white  corpuscles  are  found  between  the 
fibers. 

(6)  Purulent  Myocarditis.— This  form  occurs  quite  com- 
monly in  the  dog,  less  commonly  in  cats  and  birds,  and  is 
found  mostly  in  pyemic  conditions.  Small  abscesses  are  dis- 
tributed through  the  connective  tissue  varying  in  size  from  a 
millet  seed  to  a  pea.  Sometimes  by  confluence  the  abscesses 
are  much  larger. 

Symptoms.— In  the  early  stages  the  symptoms  are  similar 
to  those  of  insufficiency  or  weakness  of  the  heart.  The  heart 
beat  is  very  rapid,  three  to  four  times  normal,  throbbing,  and 


84  DISEASES  OF  THE  HEART 

in  the  dog  can  be  seen  quite  a  distance  from  the  animal,  the 
tumultuous  throb  of  the  heart  shaking  the  whole  body.  The 
heart  action  soon  becomes  irregular  and  very  weak.  The 
pulse  is  very  rapid,  weak,  small,  irregular  and  in  later  stages 
imperceptible.  The  pulse  usually  becomes  so  rapid  that  it 
is  impossible  to  count  it.  Respirations  are  rapid,  labored, 
and  the  animal  soon  becomes  prostrated. 

The  temperature  in  the  early  stages  is  elevated,  the  degree 
depending  upon  the  etiological  factor;  later  it  becomes 
subnormal. 

In  some  cases  myocarditis  takes  a  very  rapid  course,  the 
animals  dying  suddenly  from  rupture  or  paralysis  of  the  heart. 

Diagnosis.— This  is  difficult  as  the  symptoms  are  quite 
similar  to  endocarditis,  pericarditis,  etc.  A  careful  exami- 
nation should  always  be  made.  When  insufficiency  of  the 
heart  action  exists  without  frictional  sounds  or  bruits,  myo- 
carditis may  be  suspected. 

Prognosis.— The  prognosis  is  unfavorable,  especially  in 
secondary  myocarditis,  due  to  infection,  or  during  the  course 
of  infectious  diseases.  Even  in  primary  acute  myocarditis 
there  are  always  degenerative  changes  in  the  heart  muscle 
which  are  impossible  to  entirely  overcome.  If  recovery 
occurs  it  is  as  a  rule  only  partial  (chronic  myocarditis). 

Treatment.—  Hygienic.— The  animal  should  be  kept  in  a 
quiet  place,  avoiding  all  excitement  or  handling. 

Medical.— The  heart  weakness  should  be  treated  by  using 
heart  stimulants  and  tonics,  such  as  dilute  alcohol  (2.0- 
4.0);  fluidextract  digitalis  (0.075-0.10);  caffein  citrate 
(0.5-1.0  subcutaneously  every  six  to  ten  hours);  ether  (2.0- 
4.0  subcutaneously);  oil  camphor  (1.0-4.0  subcutaneously); 
or  atropin  sulphate  (0.04-0.075  subcutaneously).  The  use 
of  these  preparations  will  depend  largely  upon  the  needs  of 
the  case. 

In  very  acute  cases  there  is  no  treatment  that  will  produce 
satisfactory  results. 

Chronic  Myocarditis.— Definition.— A  chronic  inflamma- 
tion of  the  myocardium.  This  condition  occurs  frequently 
in  small  animals  but  is  rarely  recognized  during  life.  It  is 
often  confused  with  other  heart  affections. 


ACUTE  ENDOCARDITIS  85 

Etiology.  — (a)  Occurs  commonly  from  mild,  acute  attacks, 
especially  in  those  cases  where  the  interstitial  connective 
tissue  is  primarily  involved. 

(6)  During  the  course  of  chronic  muscular  or  articular 
rheumatism  in  old  dogs;  also  from  chronic  nephritis,  tuber- 
culosis, pericarditis,  endocarditis  of  dogs,  cats  and  birds. 

(c)  Chronic  poisoning  by  chemicals,  toxins,  etc.,  often 
will  produce  the  condition  by  interfering  with  the  circulation 
through  the  coronary  arteries. 

Necropsy. — Throughout  the  heart  muscle  appear  circum- 
scribed masses  of  fibrous  tissue  which  are  white  in  color  and 
of  firm  to  hard  consistency.  They  occur  most  conspicuously 
near  the  apex  of  the  left  ventricle.  The  fibrous  areas  may  be 
quite  dense,  like  a  cicatrix,  constituting  the  so-called  "  heart- 
scar."  Pigment  and  calcareous  deposits  may  be  present  in 
them.  The  affected  heart  wall  becomes  very  thin  in  places 
and  may  bulge  forming  a  so-called  aneurysm.  Fatty  degener- 
ation may  be  present.  The  heart  may  show  hypertrophy 
with  dilatation. 

ACUTE  ENDOCARDITIS. 

Definition.— An  acute  inflammation  of  the  endocardium, 
especially  involving  the  part  covering  the  valves.  This  con- 
dition occurs  very  commonly  in  small  animals,  especially  in 
dogs  and  birds. 

Etiology.  — 1.  The  acute  endocarditis  in  the  majority  of 
cases  results  from  infection,  the  toxins  of  a  number  of  infec- 
tious diseases  irritating  the  endocardium.  The  organisms 
(pus-producing  organisms,  bipolar  bacillus,  colon  bacillus, 
Bacterium  tuberculosis,  etc.),  or  their  toxins,  are  the  ones 
most  commonly  accused.  An  acute,  primary,  infectious 
endocarditis  is  observed  occasionally;  in  the  majority  of 
cases,  however,  it  occurs  secondary  to  other  diseases,  pyemia 
and  septicemia  usually  producing  it.  It  develops  often  also 
after  abscesses,  wounds  on  the  skin,  abscesses  in  the  internal 
organs,  septic  metritis,  sapremia,  etc.  The  organisms  or 
their  products  (toxins)  are  carried  by  the  blood  to  the  endo- 
cardium where  they  become  lodged,  especially  along  the 


86 

edge  of  the  valves.  They  propagate,  produce  irritation,  and 
assisted  by  the  mechanical  action  of  the  valves,  an  active 
inflammatory  reaction  is  soon  established.  The  inflammation 
spreads  to  the  other  parts  of  the  endocardium  and  may  cause 
a  general  endocarditis.  The  rapidity  of  the  process  depends 
upon  the  virulency  of  the  infection  or  the  amount  of  the 
toxins  present. 

2.  Spread  of  the  inflammation  from  adjacent  structures 
or  organs  may  produce  the  condition,  such  as  from  a  myo- 
carditis, pericarditis,  pleuritis,  or  a  pneumonia. 

3.  There  are  several  predisposing  conditions  which  should 
be  considered:  (a)  ("hilling  the  surface  of  the  body,  such  as 
exposure  to  cold,  or  cold  baths,  carelessness  in  thoroughly 
drying  the  skin  of  animals  after  baths,  etc.,  make  them  more 
susceptible  to  infection  by  reducing  resistance. 

(6)  In  old  animals  degenerative  changes  of  the  heart 
muscle,  valves,  etc.,  make  them  less  resistant. 

(c)  Young  puppies,  chicks,  kittens,  from  hereditary  influ- 
ences, often  favor  the  development  of  the  condition. 

(d)  During  convalescence  from  long-continued  diseases 
there  is  a  predisposition  to  endocarditis. 

(e)  Traumatic  conditions  over  the  region  of  the  heart 
(kicks,  blows,  fractured  ribs,  etc.). 

4.  Mineral  poisons  (mercury,  phosphorus,  etc.)  or  some 
drugs  administered  in  large  doses,  or  for  too  long  a  period, 
produce  direct  irritation  to  the  endocardium,  or  predispose 
to  the  condition. 

In  the  etiology  of  endocarditis,  infection  must  always  be 
regarded  as  the  principal  causative  factor. 

Necropsy.— Macroscopically  two  forms  of  acute  endocar- 
ditis are  recognized,  viz.: 

(a)  Endocarditis  Vahularis  Vernicosa.— This  is  charac- 
terized by  small  enlargements,  about  the  size  of  a  millet 
seed",  on  the  free  edges  of  the  valves,  on  the  tendons  and 
papillary  muscles.  They  are  nodular,  wart-like  in  appear- 
ance, grayish-white  or  whitish-yellow  in  color,  and  their 
surface  covered  with  blood-stained  or  colorless  stratified 
epithelium.  The-e  growths  may  develop  into  large  polypous 
proliferations,  which  often  cause  stenosis  of  the  openings 


ACUTE  ENDOCARDITIS  87 

and  insufficiency  of  the  valves  of  the  heart.  The  endocar- 
dium in  general  is  swollen,  opaque,  reddened  somewhat,  and 
covered  with  a  thin  coagulum;  small  hemorrhagic  foci  are 
found  often  in  the  subendocardial  tissue,  as  well  as  between 
the  fibers  of  the  heart  muscle. 

(6)  Endocarditis  Ulcerosa.—T\\is  is  the  more  severe  form 
of  the  condition,  characterized  by  necrosis  and  ulceration 
of  the  margins  of  the  valves  and  other  portions  of  the  endo- 
cardium. The  ulcers  are  usually  well  defined,  isolated  and 
vary  considerably  in  size  from  a  pea  to  several  times  larger. 
They  are  covered  with  friable,  discolored,  necrotic  masses. 
These  masses  are  often  torn  loose  by  the  circulating  blood 
and  are  carried  to  the  other  organs,  even  to  the  heart  itself, 
forming  metastatic  abscesses.  In  dogs  endocarditis  verru- 
cosa  is  very  commonly  found  on  postmortem  and  although 
the  lesions  may  be  extensive  no  marked  symptoms  were 
noted  during  life.  The  aortic  or  bicuspid  valves  are  most 
often  affected. 

Symptoms.— The  symptoms  of  acute  endocarditis  vary 
considerably,  depending  to  a  great  extent  upon  the  cause, 
and  the  nature  and  extent  of  the  inflammatory  process. 

The  early  symptoms  are  those  of  a  greatly  disturbed  heart 
action,  which  is  at  first  palpitating  and  irregular;  later  the 
beat  is  diffuse.  The  number  of  heart  beats  sometimes  exceeds 
that  of  the  pulse  (Frohner) .  The  heart  beat  is  often  so  tumul- 
tuous, especially  in  dogs,  that  the  entire  body  is  shaken  and 
can  be  observed  some  distance  from  the  animal. 

The  pulse  is  very  rapid,  intermittent,  irregular,  and  in  the 
later  stages  becomes  imperceptible.  The  frequency  in  dogs 
will  be  120-300,  and  in  other  animals  even  more  rapid.  The 
heart  muscle  is  at  first  normal,  but  soon  becomes  abnormal, 
the  sounds  often  blended  to  a  single  sound.  Later,  charac- 
teristic endocardial  bruits  are  heard,  a  blowing,  stenotic 
(systolic)  noise  occurring  with  the  first  heart  sound,  and  at 
times  a  prolonged  rustling  and  vibrating  sound  occurs  at 
diastole. 

The  temperature  in  the  early  stages  is  always  high  (10.T- 
105°  F.),  but  in  the  dog  it  becomes  normal  or  subnormal. 
Cats  have  a  high  temperature,  which  remains  high  for  a 


88  DISEASES  OF   THE  HEART 

longer  period  than  in  the  dog.  The  respirations  are  acceler- 
ated, the  dyspnea  similar  to  that  of  pneumonia,  a  disease  with 
which  it  is  sometimes  confused  in  making  a  diagnosis. 

In  the  later  stages  of  the  condition,  circulatory  disturbances 
are  quite  prominent.  These  are  manifested  by  cyanosis, 
venous  pulse,  edema  of  the  lungs,  etc.  In  the  septic  form  a 
hemorrhagic  diathesis  appears  with  hemorrhages  from  the 
membranes,  bloody  urine,  etc.  As  general  symptoms, 
depression,  weakness,  etc.,  come  on  rapidly,  the  animal  often 
shows  complete  prostration. 

Diagnosis.— Acute  endocarditis  is  quite  difficult  to  recog- 
nize as  the  symptoms  are  similar  to  other  diseases  of  the  heart. 
It  may  be  confused  with  any  acute  febrile  disease  having  a 
sudden  onset  (septicemia,  inflammation  of  the  brain,  pneu- 
monia, etc.).  A  careful  examination  of  the  heart  is  always 
necessary  for  a  diagnosis.  It  is  often  very  difficult,  and  in 
some  cases  quite  impossible  to  distinguish  between  acute 
endocarditis  and  myocarditis,  with  which  it  is  very  closely 
associated.  Between  the  two  forms  of  endocarditis  it  is 
almost  impossible  to  differentiate.  In  the  ulcerous  form  the 
onset  is  more  rapid  than  in  the  verrucose,  and  sometimes  the 
primary  seat  of  infection  can  be  located. 

Prognosis.— The  prognosis  is  unfavorable,  especially  in  the 
ulcerous  form.  Complete  recovery  is  rare.  The  valves  are 
usually  left  permanently  impaired  resulting  in  valvular 
insufficiency. 

The  course  of  the  disease  varies.  It  is  sometimes  very 
acute,  ending  in  death  in  a  few  hours  or  days  (endocarditis 
ulcerosa).  Or  the  condition  may  last  for  several  days  or 
weeks,  eventually  developing  into  the  chronic  form  (endo- 
carditis valvularis  verrucosa) . 

Treatment.— The  animals  should  be  kept  in  an  absolutely 
quiet  place  avoiding  all  excitement  or  movement. 

In  the  early  stages  (in  dogs  especially)  cold  compresses 
should  be  applied  over  the  region  of  the  heart  (ice-bag  or 
cold  water  compress).  These  should  be  changed  as  often 
as  necessary. 

Regulate  the  action  of  the  heart  by  the  u.se  of  digitalis,  or 
if  the  heart  is  very  weak,  it  should  be  stimulated  by  the  use 


HYPERTROPHY  AND  DILATATION  OF  THE  HEART     89 

of  alcohol,  caffein  citrate  or  ether  subcutaneously.  To  reduce 
the  temperature  acetanilid  (dog  0.2-0.5;  cat  0.05-0.1)  should 
be  given  twice  daily. 

In  endocarditis  from  rheumatic  conditions,  salicylic  acid 
or  sodium  salicylate  (dog  0.2-0.5;  cat  0.05-0.1)  should  be 
administered  twice  daily. 

When  general  weakness  is  well  marked,  stimulants  must 
be  administered  according  to  the  needs  of  the  patient. 
Camphor,  ether,  or  atropin  are  best  for  this  purpose. 

HYPERTROPHY  AND  DILATATION  OF  THE  HEART. 

Definition.— Hypertrophy  is  an  enlargement  of  the  heart 
due  to  a  thickening  of  its  musculature;  dilatation  is  an 
increase  in  the  size  of  the  heart  from  an  enlargement  of  its 
cavities.  From  a  clinical  standpoint  a  distinction  between 
them  cannot  be  made  as  they  nearly  always  coexist.  Hyper- 
trophy is  an  active  enlargement  of  the  heart,  while  dilatation 
is  a  passive  one. 

Etiology. — Generally  speaking  the  causes  of  hypertrophy 
of  the  heart  are  those  conditions  which  interfere  with  the 
circulation  of  the  blood  and  thus  increase  the  blood  pressure. 
The  following  are  the  most  common: 

(a)  Increased  physical  exertion.    This  occurs  in  dogs  used 
for  hunting  (fox  hounds,  greyhounds) . 

(b)  Adhesions  between  the  pericardium  and  heart  inter- 
fering with  the  heart  action. 

(c)  Obstruction  to  the  free  circulation  through  the  arteries, 
such  as  aneurysms  of  the  aorta,  stenosis  of  the  aorta,  thrombi, 
atheromatous  and  arteriosclerotic  processes,  etc. 

(d)  Defects  in  the  valves  of  the  heart  (chronic  endocar- 
ditis). 

(e)  Diseases   of  the   lungs,   such   as   chronic   interstitial 
pneumonia   (common  in  the  dog),   adhesions,   exudations, 
abscesses,    chronic    bronchitis,  which    increase    the    blood 
pressure  through  the  right  heart. 

(/)  Chronic  inflammation  of  the  liver,  kidneys,  etc.,  by 

impeding  the  free  circulation  of  blood  (common  in  old  dogs). 

(0)  Dilatation  of  the  heart  usually  follows  hypertrophy, 


90  DISEASES  OF  THE  HEART 

the  hypertrophied  heart  eventually  growing  weaker  and 
becoming  distended  by  the  abnormally  increased  blood 
pressure.  It  may  also  develop  in  an  acute  form  after  acute 
diseases  of  the  lungs,  as  the  circulation  through  the  right 
heart  is  greatly  interfered  with. 

Necropsy.— In  both  hypertrophy  and  dilatation  the  heart 
is  enlarged,  in  hypertrophy  the  increase  in  the  thickness  of 
the  walls,  in  dilatation  in  an  enlargement  of  its  cavities. 

(a)  True  hypertrophy  of  the  heart  appears  in  several 
forms,  depending  upon  whether  it  is  general  or  local,  i.  e., 
involving  a  whole  ventricle,  or  circumscribed  affecting  only 
some  of  the  papillary  muscles.  The  left  heart  is  most  fre- 
quently affected.  In  hypertrophy  the  shape  of  the  heart 
will  vary.  When  the  left  heart  is  involved  it  appears  elon- 
gated, cylindrical;  when  the  right  heart,  it  is  flatter  and 
broader  than  normal.  If  the  whole  heart  is  hypertrophied 
it  assumes  a  round  or  oval  form  and  is  increased  in  size.  The 
walls  are  usually  two  or  three  times  the  normal  thickness, 
the  muscles  firmer,  tougher,  darker  red  in  color,  and  the  inter- 
stitial connective  tissue  occasionally  shows  marked  prolifera- 
tion. Sometimes  areas  of  fatty  degeneration  are  noted  on  the 
surface. 

(6)  In  dilatation  of  the  heart  the  cavities  are  found  much 
larger  than  normal,  and  the  wralls  thinner  and  weaker.  In 
the  active  form  of  dilatation  the  walls  are  stronger  than  in 
the  passive  where  they  are  relaxed  and  distended.  Dilatation 
appears  oftener  in  the  right  heart  than  in  the  left.  The 
structure  of  the  muscles  may  be  normal.  Usually,  however, 
the  organ  is  anemic,  friable,  the  musculature  yellowish- 
brown  in  color,  often  very  thin,  and  due  to  a  complete  atrophy 
of  the  muscle,  in  some  areas  the  wall  is  almost  transparent. 

Symptoms.  — In  true  hypertrophy  of  the  heart,  especially 
compensatory,  the  development  is  often  so  gradual  that  it 
may  exist  for  a  long  period  without  producing  marked  symp- 
toms. In  severe  cases,  when  accompanying  other  diseases,  it 
is  characterized  by  a  strong,  full  pulse,  very  loud,  clear  heart 
sounds,  and  an  increase  in  the  area  of  cardiac  dulness.  Due 
to  the  coexistence  of  dilatation  the  symptoms  which  charac- 
terize hypertrophy  are  rarely  noted  in  practice.  The  most 


HYPERTROPHY  AND  DILATATION  OF  THE  HEART      91 

prominent  symptom  of  hypertrophy  with  dilatation  is  the 
extension  of  cardiac  dulness,  which  in  dogs  may  reach  as  far 
back  as  the  last  rib,  or  even  to  the  false  ribs. 

Dyspnea,  palpitation,  disturbances  in  the  circulation, 
dizziness,  etc.,  are  resulting  symptoms.  A  prominent  sign 
is  the  throbbing  of  the  heart,  which  often  shakes  the  whole 
body  and  may  be  seen  quite  a  distance  from  the  animal. 
The  heart  sounds  are  usually  irregular,  the  first  sound  loud, 
metallic  and  sometimes  vibrating;  the  second  sound  very 
weak  and  often  imperceptible.  The  slightest  exertion  will 
produce  a  very  rapid  heart  action.  The  pulse  is  weak.  A 
venous  pulse  is  common  in  old  dogs.  Ultimately,  due  to 
insufficient  heart  action,  general  cyanosis,  ascites,  hydro- 
thorax,  etc.,  develop. 

Diagnosis.— Care  should  be  taken  not  to  confuse  hyper- 
trophy and  dilatation  with  diseases  of  the  lungs,  and  other 
affections  of  the  heart.  The  increase  in  the  area  of  cardiac 
dulness,  the  abnormally  loud,  systolic  sound,  arhythmic 
pulse,  and  tendency  for  ascites  and  edemas  are  all  charac- 
teristic of  dilatation  of  the  heart.  A  hard,  full  pulse  with 
increased  areas  of  dulness  points  to  hypertrophy  of  the  heart. 

These  conditions  usually  can  be  distinguished  from  val- 
vular defects  by  the  absence  of  the  characteristic  bruits. 

Prognosis.— Favorable  in  simple  hypertrophy  of  the  heart. 
Unfavorable  in  dilatation  of  the  heart,  except  in  the  very 
acute  cases. 

Treatment.— Absolute  rest  and  quiet  should  always  be 
insisted  upon.  It  is  important  to  remove  the  causes  of  these 
conditions  if  possible. 

(a)  In  hypertrophy  of  the  heart  with  hyperkinesis,  seda- 
tives such  as  potassium  iodid  (dogs  0.2-0.8;  cats  0.05-0.10) 
to  act  as  a  general  sedative  may  be  used  for  one  or  two  doses. 

(6)  In  hypertrophy  complicated  by  dilatation,  with  a 
weak,  feeble  heart  action,  cardiac  tonics  and  stimulants  are 
indicated.  Digitalis  fluidextract  (dogs  0.1-0.3,  cats  half 
the  quantity)  is  probably  the  most  important  drug  for  this 
condition.  These  doses  may  be  repeated  as  often  as  neces- 
sary. Good,  nutritious  food  should  be  allowed  at  all  times. 
General  stimulants  are  to  be  used  when  necessary. 


92  DISEASES  OF  THE  HEART 

RUPTURE  OF  THE  HEART. 

Etiology.  — (a)  Traumatic  influences  (kicks,  fractured  ribs, 
being  run  over,  falling,  etc.).  (6)  Diseases  of  the  muscular 
walls  of  the  heart  (abscesses,  fatty  degeneration  and  infiltra- 
tion, endocarditis  and  myocarditis,  atheromatous  degenera- 
tions of  the  aortic  walls  at  their  origin,  etc.).  (c)  Shock 
from  operations,  and  other  conditions  and  diseases. 

Symptoms.— In  most  cases  the  animal  dies  apoplectic. 
In  cases  where  the  rupture  is  very  small,  symptoms  of  internal 
hemorrhage  are  noticeable.  Death  in  these  cases,  however, 
usually  occurs  in  a  few  hours. 

Treatment. — No  treatment  can  be  given  in  this  condition. 


PART  III. 
DISEASES  OF  THE  DIGESTIVE  TRACT. 


CHAPTER   I. 
DISEASES  OF  THE  MOUTH. 

Examination. — The  examination  of  the  oral  cavity  requires 
good  light  (daylight)  or  in  some  cases  artificial  light  (electric- 
bulb  with  reflector)  is  necessary  where  a  careful  examination 
is  to  be  made.  In  docile  animals  the  mouth  can  be  opened 
by  pressing  the  lips  against  the  teeth  above  and  below  causing 
the  animal  to  open  the  jaws.  For  protracted  examination 
it  is  necessary  to  hold  the  mouth  open  by  the  use  of  tapes 
placed  just  back  of  the  canines,  one  tape  above  and  one  below, 
which  are  grasped  by  an  assistant ;  or  a  mouth  speculum  may 
be  used.  In  vicious  animals  an  anesthetic  should  be  employed 
(morphin  for  dogs;  ether  for  cats).  For  examination  of  the 
posterior  part  of  the  cavity,  the  tongue  should  be  depressed 
with  a  spatula,  or  pulled  well  forward  with  the  fingers  or 
blunt  forceps.  In  examining  the  mouth,  the  following 
should  be  observed : 

(a)  Odor.— An    offensive    odor    is    noted   from   retained 
or  decomposed  food;  ulcerative  or  gangrenous  stomatitis; 
gangrene  of  the  lungs;  fetid  bronchitis;  acute* and  chronic- 
gastritis;  caries  of  the  teeth;  roup  in  birds.     The  odor  is 
often   characteristic   and   readily   distinguished.     In   some 
poisonings  the  odor  of  the  drug  is  evident  (carbolic  acid, 
hydrocyanic  acid,  etc.). 

(b)  Secretions.— Secretion  is  diminished  in  all  acute  febrile 
conditions;  in  some  poisonings  (belladonna,  atropin).    Secre- 


94  DISEASES  OF  THE  MOUTH 

tion  is  increased  in  parotitis;  inflammatory  conditions  of  the 
mouth;  injuries;  foreign  bodies;  poisons  (calomel);  eruption 
of  teeth  in  puppies;  following  injections  of  pilocarpin.  An 
abnormal  quantity  of  saliva  is  noted  in  the  mouth  in  dys- 
phagia.  The  saliva  which  flows  from  the  mouth  is  in  clear 
strands  or  in  the  form  of  foam  from  masticatory  movements. 

(c)  The  Mucous  Membranes. — An  anemic  or  pale  condition 
is  found  in  chronic  constitutional  diseases;  intestinal  para- 
sites; skin  parasites,  especially  in  birds;  severe  hemorrhage. 
A  hyperemic  or  congested  condition  is  noticed  in  all  acute 
inflammatory  conditions;  in  acute  infectious  diseases  with 
elevation  of  temperature;  occurs  during  the  course  of  gas- 
tritis.    Cyanosis  occurs  from  chronic  heart  diseases;  inter- 
ference with  respiration  or  the  local  circulation.    A  blue  line 
is  seen  around  the  gums  in  lead  poisoning. 

(d)  Foreign    Bodies.— A.  careful   examination   should  be 
made  for  foreign  bodies  which  often  become  imbedded  in 
the  mucous  membrane  or  around  the  tongue  or  forced  in 
between  the  teeth.     In  cats'  fishbones,  needles  or  pins  are 
often  found  in  the  posterior  part  of  the  mouth. 

(e)  Neoplasms.— Papillomata  are  frequently  seen  on  the 
margins  of  the  lips  or  on  the  mucous  membrane  in  various 
parts  of  the  mouth.    Retention  cysts  often  occur  under  the 
tongue  (submaxillary  gland),  inner  surface  of  the  lips  and 
cheeks    (buccal    glands).    'Other   tumors   are   occasionally 
found.    In  all  cases  where  the  mouth  is  held  open,  whether 
from  complete  or  partial  paralysis  or  foreign  bodies,  dumb 
rabies  should  be  suspected  and  the  examination  made  with 
care. 

STOMATITIS. 

Several  varieties  of  stomatitis  are  met  with  in  practice  as 
follows:  (a>  Catarrhal;  (6)  ulcerative;  (<•)  gangrenous;  (d) 
phlegmonous;  (e)  parasitic. 

Catarrhal  Stomatitis.— Definition.— An  acute  or  chronic 
inflammatory  condition  of  the  mucous  membrane  of  the 
mouth. 

Etiology.— Mechanical.— Injuries  from  foreign  bodies  or 
sharp  material  in  the  food  (bones,  etc.);  from  irritation  due 


STOMATITIS  95 

to  tartar  around  the  teeth;  dentition;  weed  hairs  penetrating 
the  membrane  (seen  in  hunting  dogs  after  running  in  fields). 

Chemical— Irritating  medicinal  agents  administered  in 
concentrated  form;  poisons  (carbolic  acid,  arsenic,  mercury, 
etc.) ;  decomposed  food  which  has  been  retained  in  the  mouth; 
internal  administration  of  calomel  or  lead  compounds  in 
too  large  doses  or  for  too  long  a  time. 

Thermic. — Hot  food  or  drink. 

Infectious. — It  occurs  in  the  suckling  young  of  bitches 
affected  with  infectious  mammitis;  accompanies  infectious 
diseases  (septicemia,  distemper  in  dogs  and  cats,  diphtheria 
and  roup  in  birds) ;  usually  present  during  the  course  of  gas- 
tritis, some  of  the  toxins  when  absorbed  into  the  circulation 
are  secreted  with  the  saliva  and  thus  cause  irritation  to  the 
oral  mucous  membrane;  produced  by  extension  of  inflamma- 
tion from  other  parts  (pharynx,  larynx  and  salivary  glands) . 

Chronic  constitutional  diseases  (rachitis,  anemia  and 
leukemia)  are  predisposing  factors. 

Pathology. —There  is  at  first  a  superficial  redness  and  dry- 
ness  of  the  mucous  membrane  followed  by  an  increased  secre- 
tion and  swelling.  This  secretion  collects  around  the  teeth 
and  on  the  tongue  in  the  form  of  a  dirty  gray  or  brown  coat- 
ing. The  lips  often  become  fissured  and  ulcerated. 

Symptoms.—  The  animal  shows  pain  during  mastication 
and  has  an  increased  thirst.  On  direct  examination  the 
mucous  membranes  are  seen  to  be  red,  swollen,  and  covered 
with  mucus.  The  redness  may  be  in  spots  or  diffuse,  depend- 
ing on  the  cause.  Saliva  often  flows  from  the  mouth  or  hangs 
in  strings  from  the  lips.  The  swelling  of  the  mucous  mem- 
brane may  occlude  ducts  of  the  buccal  glands,  forming  cysts 
which  appear  as  small  gray  nodules  on  the  inner  surface  of 
the  lips.  Quite  frequently  there  is  an  edematous  condition 
of  the  mucous  membrane.  The  upper  surface  of  the  tongue 
shows  a  brown  or  greenish-brown  discoloration.  In  cats  it 
is  slightly  yellow,  and  the  papillae  are  enlarged  and  quite 
prominent.  In  birds  the  epithelium  is  thickened,  tongue 
dry,  and  a  pseudomembrane  is  often  noticed. 

Diagnosis.— The  diagnosis  is  made  by  the  absence  of  general 
symptoms,  the  inflamed  and  sensitive  mucous  membrane 
and  the  characteristic  conditions  noted  above. 


96  DISEASES  OF  THE  MOUTH 

Prognosis.— Favorable  in  primary  cases,  healing  occurring 
in  about  one  week;  in  secondary  cases  it  depends  on  the 
causative  disease. 

Treatment.—  Dietetic.— The  animal  should  be  fed  warm 
liquid  food  in  small  amounts. 

Medical.— The  use  of  antiseptic  mouth  washes  is  indicated 
(boric  acid  2  per  cent.,  alum  or  tannic  acid  1  per  cent., 
vinegar  and  water  1-10) ;  in  the  severe  chronic  form  direct 
application  of  silver  nitrate  (1-2  per  cent.)  may  be  found 
useful.  Tincture  of  myrrh  applied  direct  to  the  gums  is  very 
useful  as  a  deodorant  and  antiseptic. 

Surgical.—  Remove  foreign  bodies  and  tartar  from  around 
the  teeth,  using  a  curette. 

Ulcerative  Stomatitis.— Fetid  Stomatitis.  Stomacace.  Sore 
Mouth.— Definition.—  An  acute  inflammation  of  the  mucous 
membrane  of  the  mouth  resulting  in  the  formation  of  ulcers, 
which  appear  most  commonly  on  the  margins  of  the  gums. 

Etiology.— This  disease  is  found  in  weak,  anemic  dogs  and 
cats.  It  also  frequently  develops  during  the  course  of  dis- 
temper, rachitis  and  other  constitutional  diseases.  It  is 
found  commonly  in  old  dogs  and  cats  with  diseases  of  the 
teeth  (caries) ,  especially  when  these  animals  are  insufficiently 
nourished.  The  exact  causes  producing  this  necrosis  of  the 
tissues  are  not  definitely  known.  The  character  of  the  dis- 
ease process  points  to  infection.  In  man  a  similar  disease  is 
contagious.  The  Bacillus  septicus  has  been  isolated  from 
the  diseased  area  in  dogs,  and  the  Bacillus  necrosis  and 
Bacillus  coli  communis  in  cats,  but  have  not  been  proved  to 
be  the  specific  cause.  Lack  of  cleanliness  in  the  mouth, 
diseased  teeth  and  accumulations  around  them  favor  the 
occurrence  of  the  disease.  The  internal  administration  of 
mercury  in  large  or  long  continued  doses,  may  produce  a 
similar  condition  of  the  gums. 

Pathology.— The  gums  at  first  are  swollen  and  dark  red 
in  color,  but  soon  become  pale  yellowish  and  necrotic.  The 
epithelium  is  destroyed,  deep  ulcers  form,  suppuration  ensues 
and  the  teeth  may  become  loose  and  fall  out. 

Symptoms.— In  the  early  stages  it  begins  as  a  severe 
stomatitis,  the  gums  bleed  freely,  are  swollen  and  partly 


STOMATITIS  97 

envelop  the  teeth,  but  as  their  margins  ulcerate  and  recede 
the  teeth  become  more  and  more  exposed.  The  ulcerative 
process  may  spread  to  the  contiguous  parts  destroying  much 
tissue.  Salivation  is  profuse  and  the  odor  of  the  breath  very 
fetid.  Chewing  and  swallowing  are  difficult.  The  tempera- 
ture is  usually  slightly  increased.  In  severe  cases  the  afferent 
lymph  glands  are  enlarged  and  symptoms  of  septicemia 
may  be  noted. 

Diagnosis.— This  condition  should  be  distinguished  from 
scorbutus.  The  chief  differential  features  are  the  absence 
of  general  symptoms  and  the  free  bleeding  of  the  gums,  both 
of  which  are  more  marked  in  scorbutus.  The  anamnesis  will 
usually  differentiate  ulcerative  stomatitis  from  poisons;  the 
characteristic  general  symptoms  of  the  latter  are  also  evident. 

Prognosis.— A  favorable  termination  of  the  disease  is  only 
to  be  expected  in  young,  healthy  animals  with  mild  affection. 
In  such  cases,  the  course  is  from  one  to  three  weeks.  In 
severe  cases  in  weak  anemic  animals  the  prognosis  is  unfavor- 
able. Complete  healing  is,  however,  rare;  death  may  occur 
suddenly  from  septicemia. 

Treatment.— Medical.— Potassium  chlorate  seems  to  be 
nearly  a  specific  for  this  condition.  It  may  be  administered 
internally  (0.3-0.6)  three  times  daily,  and  also  applied  as  a 
mouth  wash.  As  potassium  chlorate  is  toxic,  its  use  should 
not  be  prolonged.  When  there  is  much  fetor,  a  solution  of 
potassium  permanganate  (2  per  cent.)  can  be  used  as  a 
mouth  wash  and  silver  nitrate  (2  per  cent.)  applied  to  the 
ulcers.  In  the  mercurial  stomatitis,  a  subvariety  of  the 
ulcerative,  the  treatment  consists  in  the  removal  of  the 
cause  and  the  use  of  antiseptic  mouth  washes. 

Surgical.— Examine  the  teeth  carefully  and  remove  all 
incrustation.  Loose  teeth  should  be  extracted. 

Gangrenous  Stomatitis.— Can ker  of  the  Mouth.— Defini- 
tion.— A  disease  of  the  mouth  characterized  by  a  rapidly 
progressing  gangrene,  starting  on  the  gums  or  lips  and  pro- 
ducing extensive  sloughing. 

Etiology. — This  disease  is  usually  seen  in  young  animals 
(puppies,  kittens,  etc.)  which  have  been  kept  under  very 
unsanitary  conditions;  or  in  older  animals  convalescent 
7 


98  DISEASES  OF   THE  MOUTH 

from  infectious  diseases.  It  is  evidently  an  infectious  dis- 
ease, probably  due  to  the  Bacillus  necrophorus.  The  lack 
of  resistance  especially  in  young  animals  favors  the  develop- 
ment of  the  organisms.  Accumulations  of  filth  in  the  kennels 
and  injuries  to  the  tissues  are  predisposing  causes. 

Pathology.— The  gangrenous  area  has  the  appearance  of  a 
corroded  surface  under  which  the  mucous  membrane  seems 
transformed  into  a  dry,  finely  granular  or  firm  mass.  It  is 
grayish-yellow  in  color  and  bordered  by  a  zone  of  thickened 
tissue,  slightly  reddened  and  somewhat  granulated.  The 
necrotic  tissue  is  very  adherent  and  can  be  only  partially 
peeled  off.  The  condition  may  extend  to  the  underlying 
tissues  and  even  involve  the  bones. 

Symptoms.— Slight  salivation  and  a  disinclination  to  take 
food  are  the  first  symptoms  noticed.  An  examination  of  the 
mouth  at  this  time  may  show  an  area  of  inflammation  or 
possibly  an  erosion.  The  latter  rapidly  increases  in  size  and 
depth,  forming  a  sharply  circumscribed,  or  at  times  diffuse 
area  of  necrosis,  which  continuing  to  spread,  may  involve 
any  of  the  adjacent  tissues.  It  often  perforates  the  cheeks 
forming  a  fistulous  opening,  or  it  may  penetrate  the  hard 
palate  and  produce  a  greenish-yellow  nasal  discharge'.  With 
the  involvement  of  the  nasal  passages,  the  larynx  or  trachea 
respiration  is  disturbed.  When  life  is  prolonged  for  a  week 
or  more,  necrotic  foci  may  be  established  in  the  lungs,  giving 
rise  to  symptoms  of  bronchopneumonia.  As  the  disease 
progresses,  salivation  becomes  profuse,  deglutition  difficult 
and  the  swollen  tongue  often  protrudes  from  the  open  mouth. 
A  very  offensive  odor  is  exhaled.  W'hen  the  infection  becomes 
general  (septicemia),  the  temperature  is  elevated  (104°- 
106°  F.)  and  the  animal  shows  extreme  weakness.  Diarrhea 
is  not  uncommon  and  indicates  an  invasion  of  the  gastro- 
intestinal tract. 

Diagnosis.— This  is  made  by  the  rapid  spread  of  the  disease 
in  the  tissues  of  the  mouth,  fetid  odor  and  the  general 
symptoms. 

Prognosis.  — Ordinarily  this  disease  shows  no  tendency  to 
a  spontaneous  recovery,  and  if  untreated  death  usually 
results.  If  taken  early,  however,  it  usually  responds  to 


STOMATITIS  99 

treatment.  Under  such  favorable  conditions  the  prognosis 
is  good,  recovery  occurring  in  twelve  to  fifteen  days. 

Treatment.—  Dietetic.— As  the  animal  refuses  food  on 
account  of  the  pain  when  swallowing  it  should  be  forced  to 
take  some  nourishment  (warm  milk  can  be  given  puppies 
and  kittens;  milk  and  soups  to  older  animals). 

Surgical.— In  those  cases  where  the  lesions  are  accessible, 
the  treatment  consists  in  removing  all  the  necrotic  tissue  with 
a  curette.  This  exposes  the  causative  agent,  an  anaerobe, 
to  the  air  which  inhibits  its  growth  and  development. 

Medical.— The  skin  around  the  head,  eyes  and  mouth 
must  be  thoroughly  cleaned  with  antiseptic  washes  (boric 
acid  2  per  cent.,  potassium  permanganate  1-250).  The 
direct  application  of  carbolic  acid  (5  per  cent.),  or  Lugol's 
solution  to  the  exposed  areas  has  proved  quite  beneficial. 
In  obstinate  cases  silver  nitrate  (2  per  cent.)  may  be  used. 

Prevention. — Prevention  of  this  disease  consists  in  a  thor- 
ough disinfection  once  daily  for  a  few  days,  of  the  mouth  and 
nose  of  those  animals  that  have  been  exposed  and  are  pre- 
disposed by  the  eruption  of  the  first  teeth  or  the  shedding 
of  the  milk  teeth;  or  through  association  with  affected  animals. 
All  filth  should  be  removed  from  the  kennel  and  disinfectants 
freely  used. 

Phlegmonous  Stomatitis. —Definition.— An  acute  phleg- 
monous  inflammation  of  the  mucous  membranes  of  the 
mouth,  lips  and  tongue. 

Etiology.— M echanical.— Foods  containing  irritating  mate- 
rials. In  hunting  dogs  sharp  projections,  such  as  thorns, 
spikes,  nettles,  hairs,  etc.,  on  grasses  and  weeds  are  causes. 

Chemical.— Carbolic  acid,  alkalies,  ammonia,  croton  oil, 
etc.,  when  concentrated,  produce  an  intense  inflammation 
and  swelling  of  the  membranes. 

Infections.— It  is  produced  secondarily  during  the  course 
of  diseased  processes  of  neighboring  organs  (infectious 
pharyngitis) ;  also  secondary  to  infectious  diseases  (distemper 
in  dogs  and  cats  and  diphtheria  in  birds). 

Pathology.— The  mucous  membrane  is  reddened,  edematous 
and  covered  with  a  thick  tenacious  mucus.  The  subcu- 
taneous tissues  are  infiltrated  with  serum.  Desquamation 
of  the  epithelium  is  often  noticed  from  the  intense  irritation. 


100  DISEASES  OF  THE  MOUTH 

Symptoms.—  The  disease  begins  with  swelling,  redness  and 
a  very  painful  condition  of  the  mucous  membrane.  The 
local  temperature  is  accelerated.  The  lips  and  cheeks 
become  swollen,  the  lower  lip  hangs  down  and  strands  of 
saliva  hang  from  the  corners  of  the  mouth.  Later  the  mucous 
membranes  on  the  inner  surface  of  the  lips,  cheeks  and  the 
back  part  of  the  mouth  are  bluish-red  in  color.  The  gums 
are  swollen  and  dark  red,  the  tongue  becomes  much  thickened 
which  interferes  with  deglutition  and  forces  the  mouth  open. 
In  severe  cases  following  infectious  diseases,  the  submaxillary 
and  sublingual  lymph  glands  are  swollen  and  very  painful 
to  the  touch.  The  general  symptoms  depend  largely  upon 
the  primary  condition. 

Diagnosis.— Is  made  by  the  acute  inflammatory  condition 
of  the  mucous  membranes  with  the  swelling  of  the  lips, 
cheeks  and  tongue.  The  anamnesis  in  some  cases  will 
materially  assist  in  making  the  diagnosis. 

Prognosis.— Usually  favorable;  in  the  secondary  cases  it 
depends  on  primary  condition. 

Treatment.—  Dietetic.— All  solid  food  should  be  withheld 
for  a  few  days  and  small  quantities  of  liquid  foods  given 
(milk,  meat  broth,  etc.). 

Medical.— The  mouth  should  be  thoroughly  cleansed  twice 
daily  with  antiseptic  and  astringent  solutions  (alum  1-250; 
tannic  acid  1-250;  potassium  permanganate  1-250). 

Parasitic  Stomatitis.—  Thrush.  Soor.  Aphtha.— Definition. 
—An  inflammation  of  the  mucous  membrane  of  the  mouth 
produced  by  the  Oidium  albicans. 

Etiology.— The  Oidium  albicans  (Monilla  Candida,  Sac- 
charomyces  albicans)  is  the  exciting  cause  of  this  disease 
which  is  found  occasionally  in  healthy  young  animals,  most  fre- 
quently in  birds.  This  fungus  is  widespread  in  nature,  occur- 
ring especially  on  decaying  vegetable  matter  as  a  saprophyte. 
The  mycelia  are  composed  of  cylindrical  cells,  1-4  microns 
wide  and  10-20  microns  long.  The  filaments  show  branching 
and  the  outer  ends  are  rounded  off  or  club  shaped.  The 
rounded  ends  often  contain  oval,  highly  refractive  bodies, 
the  gonidia  or  spores,  which  are  also  found  free  between  the 
filaments.  If  the  free  spores  come  in  contact  with  the  oral 


STOMATITIS  101 

mucosa,  in  which  there  are  slight  epithelial  defects,  they  may 
develop  and  lead  to  the  formation  of  thrush  spots  and  pseudo- 
membranes.  In  some  cases  the  filaments  and  spores  may 
penetrate  deeper  into  the  tissues,  or  by  metastasis  involve 
the  internal  organs.  Frequently  in  birds,  the  spores  are 
taken  into  the  crop  where  they  develop  and  produce  typical 
thrush  lesions.  Damp,  warm  rooms  poorly  ventilated  and 
filthy,  favor  the  growth  of  this  fungus. 

Pathology.— The  affection  begins  with  diffuse  redness  of 
the  mucosa  and  the  formation  of  a  glistening  or  shiny 
adhesive  exudate  of  grayish  appearance.  Small  white  or 
yellowish  dots  next  appear,  which  stand  out  prominently 
against  the  hyperemic  background.  These  patches  may  be 
quite  large  and  when  removed  the  underlying  mucosa  is 
congested  and  eroded.  The  disease  usually  begins  on  the 
tongue  or  inner  parts  of  the  cheeks,  from  where  it  spreads 
to  other  parts  of  the  mouth.  In  severe  cases  it  may  extend 
to  the  pharynx,  esophagus,  or  even  in  fowls  to  the  crop  and 
intestines.  The  microscope  reveals  filaments,  spores,  epi- 
thelial cells  and  pus. 

Symptoms.— The  general  symptoms  are  depression,  emacia- 
tion and  loss  of  strength.  On  direct  examination  of  the  mouth 
an  acid  odor  will  be  detected  and  the  characteristic  lesions  or 
spots  will  be  seen  on  the  mucosa.  These  may  be  in  the  form 
of  white  or  yellowish  spots,  or  they  may  coalesce  forming  a 
superficial  felt-like  membrane  which  can  be  readily  scraped 
off.  Similar  membranes  form  in  the  esophagus  and  crop 
interfering  with  the  appetite  and  nutrition.  This  condition 
leads  to  cachexia  and  death,  which  is  often  preceded  by 
convulsions. 

Diagnosis.— The  disease  is  readily  distinguished  from  other 
forms  of  stomatitis  by  the  absence  of  acute  inflammation. 
The  diagnosis  is  made  positive  by  the  finding  of  the  filaments 
or  spores  of  the  fungus  in  the  deposits  on  the  membranes. 
The  clinical  appearance  may  be  confused  with  the  condition 
due  to  the  aspergillus  fungi.  (See  Aspergillosis.) 
t  Prognosis.— When  the  disease  is  localized  on  the  mucous 
membrane  of  the  mouth,  the  prognosis  is  favorable,  but  when 
it  extends  to  the  esophagus  and  crop,  treatment  is  unsatis- 
factory. 


102  DISEASES  OF   THE  MOUTH 

Treatment.—  Dietetic.—  Good  nutritious  food  should  be 
given  (small  meat  scraps,  oatmeal  and  milk,  etc.)  to  sustain 
the  strength. 

Surgical.— Carefully  curette  all  the  accessible  lesions  and 
wash  with  antiseptic  solutions  (boric  acid  2  per  cent.,  mer- 
curic chlorid  1-1000,  the  latter  used  with  care  that  it  may 
not  be  swallowed).  When  the  disease  extends  to  the  crop, 
give  enough  boric  acid  (2  per  cent.)  solution  to  distend  the 
latter,  then  massage  it  thoroughly  with  the  head  held  down 
so  the  contents  will  be  forced  out  of  the  mouth.  Repeat  this 
daily  until  the  appetite  is  improved. 


BENIGN  NEOPLASMS  OF  THE  MOUTH. 

Papillomata.  —  These  tumors  occur  on  the  mucous  mem- 
brane of  the  mouth  and  occasionally  on  the  margins  of  the 
lips  and  sometimes  they  apparently  assume  a  contagious 
character. 

Symptoms.— They  are  noticed  as  small,  isolated  or  confluent 
growths,  usually  pedunculated,  of  a  whitish  color  and  often 
rough  (cauliflower-like)  on  their  surface.  They  are  found 
most  commonly  at  the  juncture  of  the  mucous  membrane 
and  the  skin,  and  on  the  inner  surface  of  the  lips,  but  may  be 
generally  distributed  over  the  oral  mucosa.  They  rarely  inter- 
fere with  mastication,  but  when  present  in  large  numbers 
or  masses  they  may  cause  some  salivation  and  from  the 
decomposed  food  collecting  around  them  a  very  disagreeable 
odor  is  emitted. 

Treatment.— These  tumors  frequently  disappear  in  a  short 
time  without  any  treatment.  However,  it  is  best  to  remove 
them  by  clipping  off  with  scissors.  The  mouth  should  be 
washed  for  a  day  or  two  with  antiseptic  solutions  (alum 
1-250;  potassium  permanganate  1-250).  Tannic  acid  (2 
per  cent.)  applied  direct  to  small  papillomata  often  causes 
them  to  slough  off  after  a  few  applications. 

Fibromata. — These  tumors  are  composed  of  connective 
tissue  elements  which  may  be  a  pure  or  mixed  fibrous  growth 


BENIGN  NEOPLASMS  OF  THE  MOUTH  lO.'i 

containing  cartilage  and  sometimes  spicula  of  bone.  They 
have  their  origin  in  the  submucous  tissue  or  the  periosteum 
of  the  bone,  and  usually  occur  as  a  single  growth. 

Symptoms.— The  tumor  is  found  growing  at  the  edge  of  the 
gums  in  the  form  of  a  hard,  reddish  enlargement  varying 
in  size  from  a  pea  to  a  walnut.  Its  growth  is  slow  often 
requiring  months  to  develop  into  sufficient  size  to  be  notice- 
able. The  slow  growth  and  firm  consistency  assist  in  dis- 
tinguishing it  from  any  of  the  malignant  growths. 

Treatment.— Complete  extirpation  and  cauterization  of  the 
wound  with  silver  nitrate  or  thermocautery  are  curative. 

Osteoma. — These  tumors  are  found  growing  from  the  peri- 
osteum of  the  maxillae.  They  are  composed  of  osseous  mate- 
rial and  frequently  develop  after  injuries  to  the  periosteum. 

Symptoms.—  Osteomas  appear  as  very  hard  enlargements 
firmly  attached  at  their  base.  As  a  rule  the  skin  or  mucous 
membrane  is  riot  adherent  over  them.  Their  hardness  and 
slow  growth  readily  distinguish  them  from  malignant  tumors. 

Treatment.  — Expose  the  enlargement  by  an  incision  through 
the  soft  tissues  and  dissect  down  to  the  base,  when  it  may 
be  removed  if  not  too  diffuse,  by  the  use  of  bone  forceps  or  a 
small  bone  chisel.  Curette  the  surface  until  smooth  and 
suture  the  skin  over  it.  After-treatment  as  an  ordinary 
wound,  using  antiseptics  to  cleanse  it  daily. 

Retention  Cysts.—  Ramda. — These  are  enlargements  ap- 
pearing in  the  buccal  cavity  from  a  stoppage  of  the  ducts  of 
glands  which  discharge  their  secretions  into  the  mouth.  Co- 
hesion of  openings  occurs  from  inflammations  of  the  mucous 
membrane,  swelling,  etc.,  partially  or  completely  closing  the 
duct.  At  the  same  time  the  glands  continue  to  secrete  their 
fluids  which  distend  the  ducts  forming  the  enlargements. 
Closure  or  obstruction  of  Wharton's  duct  produces  an  exten- 
sive enlargement  under  the  tongue.  The  most  common 
retention  cysts,  however,  are  from  the  ducts  of  the  buccal 
or  sublingual  glands.  When  the  obstruction  is  complete 
the  secretions,  as  they  collect,  burrow  downward  along  the 
neck  producing  an  enlargement  which  appears  subcutane- 
ously  in  the  submaxillary  region,  or  may  extend  to  the  supe- 


104  DISEASES  OF   THE  MOUTH 

rior  part  of  the  neck,  appearing  as  a  soft  fluctuating  enlarge- 
ment. There  is  an  absence  of  inflammatory  symptoms  and 
the  skin  is  not  adherent  over  it.  These  cysts  develop  slowly 
in  contrast  to  a  rapidly  developing  hematoma;  the  skin  is 
adherent  in  the  latter.  The  contents  of  the  cysts  can  be 
obtained  by  the  use  of  a  large  aspirating  needle  or  trocar 
and  examined.  The  fluid  which  flows  out  very  slowly  is  a 
thick,  viscid,  honey-like  material  which  makes  the  diagnosis 
positive. 

Treatment.— Surgical.— Complete  removal  of  the  cyst  is 
hardly  possible  by  excision,  as  the  glandular  secretion  con- 
tinues, and  when  adhesion  of  the  edges  of  the  wound  takes 
place,  another  cyst  will  develop.  The  most  satisfactory 
treatment  consists  in  aspirating  all  of  the  contents  and  the 
injection  of  Lugol's  solution  or  tincture  of  iodin  to  destroy 
the  cyst  wall  and  the  secreting  gland.  The  injection  should 
be  sufficient  to  distend  the  cyst  so  that  some  of  it  will  be 
forced  to  gravitate  into  the  gland  to  destroy  it.  This  should 
be  done  every  second  or  third  day.  As  soon  as  the  gland 
,  is  destroyed,  the  secretions  will  stop,  the  gland  will  atrophy 
and  the  enlargement  disappear.  This  usually  takes  place  in 
three  to  four  weeks. 

MALIGNANT  NEOPLASMS  OF  THE  MOUTH. 

Epitheliomata.— These  tumors  appear  most  commonly  on 
the  margin  of  the  lips,  involving  the  mucous  membrane, 
subcutaneous  tissue,  muscles  and  skin.  They  occur  most 
often  in  old  animals. 

Symptoms.— In  the  beginning  they  are  observed  as  small 
flat  growths,  which  later  have  a  tendency  to  show  ulceration 
on  the  surface.  The  surface  has  a  roughened,  granulating 
appearance  often  covered  with  a  thin  dried  mass.  It  grad- 
ually develops  in  size  until  it  invades  the  entire  lip  and  occa- 
sionally the  maxillae.  Secondary  enlargement  of  the  cervical 
and  submaxillary  lymph  glands  is  of  common  occurrence. 
Epitheliomata  are  diagnosed  clinically  by  their  rapid,  pro- 
gressive growth,  roughened  irregular  surface  and  invasion 


MALIGNANT  NEOPLASMS  OF   THE  MOUTH       105 

of  the  entire  lip.  In  cases  where  a  satisfactory  diagnosis  can- 
not be  made  clinically  a  small  portion  can  be  removed  for 
microscopical  examination. 

Treatment.— Surgical.— Complete  excision  early  as  pos- 
sible. When  the  tumor  is  small  and  involving  the  lip,  a 
"V-shaped  incision  should  be  made  through  the  entire  lip 
removing  all  of  the  tissue  affected.  The  wound  should  be 
carefully  sutured  to  bring  the  edges  in  direct  apposition 
when  healing  will  readily  take  place.  In  more  diffuse  and 
extensive  growths  complete  excision  is  difficult  but  should 
be  attempted  if  at  all  possible.  When  the  lymph  glands  are 
involved  treatment  is  usually  unsatisfactory.  After-treat- 
ment consists  in  the  use  of  antiseptic  washes. 

Sarcomata.— This  tumor  most  commonly  affects  the 
maxillse,  usually  the  superior  maxilla,  as  it  originates  either 
in  the  periosteum,  the  medulla,  or  the  endosteum  of  the  bone. 
They  are  frequently  quite  large  and  often  invade  the  nasal 
passages,  the  orbits  and  the  sinuses.  Metastatic  processes 
are  common  in  the  adjacent  lymph  glands  and  occasionally 
a  generalized  sarcomatosis  is  produced. 

Symptoms.— The  growth  first  appears  as  a  rather  firm, 
oval,  reddish  colored  enlargement  in  close  proximity  to  the 
maxilla.  Later  the  surface  becomes  irregular,  lobulated  and 
covered  with  thickened  mucous  membrane.  The  tumor 
usually  has  a  broad  base  rather  firmly  attached,  but  may 
in  some  cases  be  pedunculated.  The  growth  is  quite  rapid, 
beginning  as  one  enlargement  around  which  eventually 
numerous  secondary  ones  develop;  later  by  confluence  the 
base  becomes  broad.  The  teeth  are  often  hidden  by  the 
growth  or  in  some  cases  elevated  from  their  position. 

Treatment.— The  removal  of  the  entire  growth  should  be 
done  as  early  as  possible.  Under  general  anesthesia,  dissect 
out  the  tumor,  using  bone  forceps,  chisel  or  curette,  being 
careful  to  get  out  all  the  affected  tissue.  When  the  alveoli 
are  affected,  extract  the 'tooth  and  curette  and  cauterize  the 
cavities  to  destroy,  as  far  as  possible,  all  the  sarcomatous 
cells.  When  the  lymph  glands  and  the  sinuses  are  involved 
treatment  is  practically  impossible. 


106  DISEASES  OF  THE  MOUTH 

FOREIGN  BODIES  IN  THE  MOUTH. 

Foreign  bodies  in  the  mouth  consist  principally  of  such 
objects  as  are  taken  in  the  mouth  with  food  or  during  play. 
Fragments  of  bone  are  most  common.  These  either  penetrate 
the  soft  tissues  or  are  firmly  lodged  in  between  the  teeth,  or, 
if  larger,  may  be  between  the  rows  of  teeth.  Splinters  of 
wood  and  pieces  of  wire  are  usually  found  imbedded  in  the 
mucous  membrane.  Needles,  pins  and  fish  bones  are  also 
common,  especially  in  cats.  Birds  often  have  grains  of  corn, 
sunflower  seeds,  etc.,  lodged  under  the  tongue  in  the  floor  of 
the  mouth.  Hunting  dogs  when  running  through  fields  often 
have  pieces  of  twigs  or  weeds  forced  in  the  mucous  mem- 
brane of  the  mouth.  Porcupine  quills  are  common  in  locali- 
ties where  these  animals  abound. 

Symptoms.— When  the  foreign  body  causes  much  incon- 
venience, the  animal  makes  persistent  attempts  to  remove 
it  by  pawing  at  the  mouth  with  the  feet  and  shaking  the  head. 
Masticatory  movements  may  be  continuous  or  the  mouth 
may  be  held  open,  with  some  salivation.  Smaller  objects 
as  needles,  pins,  etc.,  may  not  produce  prominent  symptoms 
at  first  and  the  former  may  only  be  noticed  by  the  presence 
of  a  thread  attached.  Food  and  drink  are  either  entirely 
refused  or  feeble  attempts  made  at  eating.  Thorough  inspec- 
tion of  the  mouth  reveals  the  foreign  body  or  the  wound 
in  the  membrane  where  it  entered. 

Treatment.— Ordinarily  objects  lodged  between  the  teeth 
may  be  readily  removed  with  forceps.  Imbedded  objects 
should  be  observed  closely  to  determine  their  direction  of 
entrance  and  removed  in  the  opposite  direction.  Vicious 
animals,  especially  cats,  should  be  etherized  to  render  the 
operation  safe. 


CHAPTER   II. 
DISEASES  OF  THE  TEETH. 

Examination.— Examination  of  the  teeth  can  be  done  by 
elevating  the  lips,  which  readily  exposes  them,  or  by  the  use 
of  tapes  or  a  mouth  speculum  to  hold  the  mouth  open  (see 
examination  of  the  mouth).  Careful  inspection  should  be 
made  for  malformations,  fractures,  incrustations  of  tartar 
and  disease  conditions. 

MALFORMATIONS  OF  THE  TEETH. 

These  are  not  common  in  small  animals,  only  occasionally 
being  seen  as  distortions  of  the  skull  bones  so  affecting  the  jaws 
that  the  teeth  do  not  meet  in  proper  relationship.  This  may 
result  in  excessively  long  teeth.  A  few  instances  of  defective 
dentition  are  recorded.  They  are  important  only  when  they 
interfere  with  mastication  and  subsequent  nutrition.  Breeding 
has  been  carried  to  such  an  extent  with  some  breeds  (English 
bull,  etc.)  as  to  amount  almost  to  a  malformation  of  the  max- 
illte  with  unusual  relationship  of  the  teeth  in  some  individuals. 
Birds  occasionally  have  a  deformity  of  the  beak  rendering 
prehension  of  food  difficult. 

Treatment.  —  Surgical.— Surgical  intervention  is  possible 
only  in  rare  cases  to  improve  the  appearance  or  condition. 
Prescribe  a  suitable  diet  when  the  animal  is  unable  to  masti- 
cate solid  food  (meat,  etc.,  should  be  given  in  small  pieces). 
Long  teeth  may  be  removed  or  the  points  clipped  off  with 
bone  forceps.  The  long  points  of  malformed  beaks  should 
be  so  shaped,  using  a  sharp  knife,  that  they  will  assume  a 
more  normal  form. 


108  DISEASES  OF  THE   TEETH 

FRACTURES  OF  THE  TEETH. 

Fractures  of  the  teeth  with  exposure  of  the  pulp  cavity 
sometimes  occur,  especially  in  dogs,  and  are  usually  due  to 
fighting,  falls  on  hard  surfaces,  kicks  (horses,  etc.),  being  hit 
with  hard  objects;  often  occur  during  play  in  attempting  to 
catch  a  ball  or  stone  when  thrown;  also  due  to  biting  iron 
bars  in  their  attempts  to  escape  from  cages. 

Treatment.— If  the  fractured  tooth  is  painful,  extract  it. 
It  is  possible  to  have  it  filled. 

INCRUSTATIONS  OF  TARTAR. 

Tartar  occurs  quite  commonly  on  the  teeth  of  dogs  and  it 
is  due  to  the  precipitation  of  the  carbonates,  phosphates  and 
some  organic  substances  from  their  solution  in  the  mouth 
secretions.  It  collects  around  the  neck  of  the  tooth  close  to 
the  gingival  border  which  is  the  least  exposed  part  of  the 
tooth,  and  therefore  the  deposits  are  not  worn  off  by  eating. 
By  constant  accretion,  these  deposits  increase,  producing  an 
irritation  to  the  gums  and  inflammation.  As  the  process 
continues,  it  separates  the  gums  from  the  teeth  and  often 
causes  the  teeth  to  loosen  and  fall  out.  In  some  severe  cases, 
the  tooth  may  be  completely  covered  with  the  incrustations. 
The  gums  are  reddened,  swollen  and  painful,  later  showing 
ulceration.  A  foul  odor  is  emitted  from  the  mouth. 

Remove  all  deposits  from  the  teeth  with  a  curette  or  scaling 
instrument,  being  careful  not  to  injure  the  gums.  Extract  all 
loose  teeth.  Tincture  of  myrrh  applied  to  the  gums  is  useful 
as  an  antiseptic,  astringent  and  deodorant.  As  this  condi- 
tion usually  persists,  these  cases  should  have  attention  every 
few  weeks. 

ALVEOLAR  PERIOSTITIS. 

Pericementitis .     Periodontitis . 

Definition.— This  is  an  inflammation  of  the  alveolar  peri- 
osteum. 

Etiology.— It  begins  in  most  cases  from  the  irritation  pro- 
duced by  a  collection  of  tartar  around  the  teeth.  As  the 


CARIES  OF  THE   TEETH  109 

incrustation  gradually  increases,  it  causes  separation  of  the 
gums  from  the  teeth  and  this  leads  to  suppuration  of  the  peri- 
dental  membrane  at  the  neck  of  the  tooth,  and,  as  the  process 
continues,  the  entire  membrane  becomes  involved. 

Pathology.— The  affected  tooth  is  loosened,  slightly  raised 
from  its  alveolus,  and,  from  disturbance  to  the  vessels  and 
nerves  leading  to  loss  of  nutrition,  it  becomes  discolored 
(dark  or  yellowish.)  Injury  to  a  tooth  with  exposure  of  the 
peridental  membrane  may  also  lead  to  a  similar  condition 
but  in  this  case  only  one  or  a  few  teeth  are  affected  while  in 
the  former  several,  or  in  severe  cases  the  entire  set  is  lost. 

Symptoms.— The  animal  either  refuses  food  or  takes  only 
a  small  amount  and  this  very  carefully.  Saliva  flows  freely 
and  the  mouth  emits  a  foul  odor.  The  gums  are  dark  red 
(livid),  swollen  and  bleed  easily.  Ulcerative  stomatitis 
often  accompanies  this  condition. 

Treatment. — Extract  all  loose  teeth  and  remove  incrusta- 
tions from  the  others.  Disinfect  the  mouth  daily  with  anti- 
septic solutions  (potassium  permanganate  1-250),  or  by 
direct  application  of  tincture  of  myrrh  to  the  gums.  Extrac- 
tion may  be  accomplished  by  the  use  of  dental  forceps,  a 
mouth  speculum  being  necessary  to  open  the  mouth  when 
molars  are  to  be  extracted  but  not  necessary  for  the  incisors. 
Grasp  the  tooth  as  far  up  the  root  as  possible  and  for  single 
fanged  teeth,  loosen  with  half  turn  twist  each  way,  and  molars 
with  a  pressure  alternately  inward  and  outward,  care  being 
taken  to  avoid  breaking  the  roots.  General  anesthesia 
should  be  used  when  the  animal  is  vicious. 

CARIES  OF  THE  TEETH. 

Definition.— Caries  is  the  true  decomposition  or  disinte- 
gration of  the  dental  tissues.  It  is  rare  in  small  animals. 

Etiology.— The  process  always  commences  on  the  surface 
of  the  tooth  where  the  enamel  is  inferior  or  damaged,  or  at 
protected  parts  of  the  tooth  where  food  particles  lodge  and 
decompose. 

Pathology.— The  point  where  this  begins  may  or  may 
not  be  discolored,  and  as  the  dentin  is  disintegrated  more 


110  DISEASES  OF   THE  TEETH 

rapidly  than  the  enamel,  a  cavity  is  soon  formed  within  the 
tooth  but  having  a  small  opening  through  the  enamel.  As 
this  process  continues  it  opens  the  pulp  cavity  which  becomes 
infected.  As  long  as  the  opening  through  the  enamel  is  free 
the  pus  will  be  discharged  without  further  complication  but 
if  it  becomes  closed  with  food  particles,  etc.,  an  abscess 
develops  at  the  root  and  the  pus  burrows  out  into  the  adja- 
cent parts,  usually  into  the  sinuses  or  may  break  down  the 
sinus  wall  resulting  in  a  maxillary  fistula.  The  disintegra- 
tion of  the  dental  tissue  is  brought  about  by  chemical  action 
from  the  lactic  acid  fermentation  in  the  mouth. 

Symptoms.— This  condition  will  be  noticed  only  by  careful 
inspection  until  the  disintegrating  process  reaches  the  pulp 
cavity  when  it  gives  rise  to  sharp  pain,  depression  of  the  head 
toward  the  affected  side  and  careful  mastication.  When  a 
fistula  results  the  pain  is  not  pronounced.  Empyema  of  the 
sinuses  often  causes  a  distortion  of  the  affected  side  and  a 
dull  sound  when  percussed.  Suspect  all  fistulse  opening  in 
the  maxillary  region  as  having  their  origin  in  a  carious  tooth. 

Treatment.— Extract  diseased  tooth  and  cleanse  the  alveo- 
lus with  antiseptic  solution  (boric  acid  2  per  cent.).  If  a 
fistula  is  present,  it  is  readily  irrigated  when  the  tooth  is 
removed.  Thorough  irrigation  through  the  entire  tract 
should  be  done  daily.  Healing  is  usually  rapid. 


CHAPTER   III. 
DISEASES  OF  THE  TONGUE. 

Examination. — This  can  be  readily  done  by  opening  the 
mouth  (see  examination  of  the  mouth)  and  pulling  the  tongue 
forward  as  far  as  possible  with  a  blunt  forceps  or  by  a  piece 
of  tape  wrapped  around  the  free  end  of  the  tongue,  using 
gentle  traction. 

In  paralysis  of  the  tongue,  it  will  be  relaxed  and  protrude 
from  one  side  of  the  mouth.  The  examination  should  be 
made  for  (a)  foreign  bodies,  splinters  of  bone,  needles,  pins, 
etc.,  which  often  penetrate  the  tongue.  (6)  Rubber  bands, 
pieces  of  bone  or  cartilage  becoming  fixed  around  the  free 
portion  of  the  tongue,  (c)  Inflammation  of  the  tongue 
(glossitis),  (d)  Necrosis  of  the  free  portion  of  the  tongue. 
(e)  Ulcerative  processes  extending  from  the  mucous  mem- 
brane of  the  mouth.  (/)  Edema  of  the  tongue  occurring 
during  the  course  of  infectious  diseases  (distemper,  etc.). 
(g)  Inflammation  of  the  glands  in  the  posterior  part  of  the 
tongue,  (h)  Deposits  on  the  tongue. 

GLOSSITIS. 

Definition.— An  inflammation  of  the  tongue. 

Etiology.— Mechanical.— Injuries  by  foreign  bodies  (pieces 
of  bone,  needles,  etc.)  which  penetrate  it;  biting  the  tongue 
or  being  bitten  by  other  animals  or  insects,  cats  being  fre- 
quently bitten  by  rats  or  mice. 

Chemical.— Medicinal  substances  taken  in  too  concentrated 
form  (carbolic  acid,  ammonia,  etc.)  or  given  for  too  long  a 
period  or  in  too  large  doses  will  lead  to  severe  glossitis. 

Thermic.— Hot  foodstuffs  or  the  tip  of  the  tongue  touched 
against  hot  objects. 


112  DISEASES  OF  THE  TONGUE 

Infectious.— Occurs  during  the  course  of  infectious  dis- 
eases (distemper,  etc.).  Glossitis  also  usually  accompanies 
the  various  forms  of  stomatitis. 

Pathology. —The  mucous  membrane  is  reddened,  swollen 
and  covered  with  a  grayish-white  membranous  deposit. 
When  foreign  bodies  are  present  at  the  point  of  entrance, 
the  tongue  is  swollen  and  edematous,  later  becoming  a  dark 
bluish  color.  In  severe  cases  foci  of  gangrene  are  seen. 

Symptoms.— The  animal  refuses  food  or  eats  very  carefully; 
the  mouth  is  often  held  open;  saliva,  sometimes  streaked  with 
blood,  runs  from  the  corners  of  the  mouth.  The  swelling 
may  be  so  great  that  the  tongue  is  protruded.  Direct  ex- 
amination reveals  the  swollen  and  reddened  condition  of  the 
tongue  and  quite  often  foreign  bodies  are  found  imbedded  in 
it  or  around  the  free  end.  As  a  rule  no  general  symptoms 
are  noticed  except  when  due  to  infectious  diseases. 

Prognosis.— The  majority  of  cases  terminate  in  recovery, 
depending  somewhat  on  the  cause  and  extent  of  the  injury. 
When  due  to  infectious  diseases,  the  prognosis  is  less  favor- 
able. 

Treatment.—  Dietetic.— \Vhen  the  swelling  interferes  with 
mastication,  soft  or  liquid  foods  should  be  given  (milk,  beef 
broth,  etc.). 

Medical.— Antiseptic  washes  (boric  acid  2  per  cent., 
potassium  permanganate  1-250,  potassium  chlorate  1-100) 
may  be  used  several  times  daily.  When  there  is  severe 
swelling,  astringent  solutions  are  also  indicated  (alum  1 
per  cent.). 

Surgical. — In  very  severe  cases  or  where  abscesses  develop, 
make  deep  incisions  in  the  substance  of  the  tongue  followed 
by  the  use  of  antiseptic  solutions. 

GANGRENE  OF  THE  TONGUE. 

Gangrenous  Glossitis. 

Definition.— This  is  a  gangrenous  condition  of  the  tongue 
which  may  involve  the  entire  free  end  or  appear  as  small 
rapidly  spreading  ulcers. 


GANGRENE  OF  THE  TONGUE         113 

Etiology.— M echanical.— Obstruction  to  the  circulation 
from  foreign  bodies  is  not  uncommon.  Rubber  bands  are 
occasionally  slipped  over  the  tongue  by  children;  rings  of 
cartilage  from  the  trachea  or  aorta  from  cadavers  upon 
which  the  dog  has  been  feeding,  have  been  found  around  the 
tongue. 

Infectious. — Gangrene  of  the  tongue  may  be  caused  by  the 
Bacillus  necrophorus  and  often  is  associated  with  gangrenous 
stomatitis. 

Chemical.— The  action  of  concentrated  drugs  may  be  so 
severe  as  to  cause  a  gangrene. 

Pathology.— When  the  tongue  is  encircled  by  foreign 
bodies  which  shut  off  the  blood  supply  that  part  of  the  tongue 
anterior  to  the  foreign  body  becomes  swollen  and  in  a  few 
hours  very  dark  and  gangrenous  and  will  slough  off  in  three 
or  four  days.  In  cases  of  infection,  the  process  begins  as  a 
small  ulcer  which  rapidly  extends  and  may  involve  the  entire 
organ.  Chemicals  usually  cause  only  small  areas  of  gangrene 
which  do  not  show  a  tendency  to  spread. 

Symptoms.— The  animals  refuse  food  and  drink,  and  saliva 
flows  freely.  If  the  tongue  is  much  swollen  it  may  protrude 
from  the  mouth.  The  inconvenience  causes  the  animal  to 
appear  depressed.  General  disturbance  is  not  noticed  in  the 
early  stages  but  later,  from  the  absorption  of  the  gangrenous 
toxins,  an  elevation  of  temperature  and  symptoms  of  sapremia 
are  seen. 

Diagnosis.— The  presence  of  the  foreign  body  around  the 
tongue  partly  obscured  by  the  swelling,  or  in  infection  the 
rapidly  spreading  ulcer. 

Prognosis.— This  depends  on  the  degree  of  compression 
by  the  foreign  body,  and  the  length  of  time  it  has  been  on 
the  tongue.  Complete  obstruction  of  the  blood  supply  for  a 
few  hours  (4-6)  will  often  result  in  loss  of  the  tongue.  The 
infectious  form  is  favorable  if  treated  early. 

Treatment.  —  Remove  the  cause  if  a  foreign  body.  When 
due  to  infection  or  chemicals,  remove  the  necrotic  material 
with  a  curette  and  thoroughly  cleanse  with  antiseptic  solu- 
tions (see  Gangrenous  Stomatitis.)  After  removing  the 
foreign  body  from  around  the  tongue  a  few  hours  should 
8 


114  DISEASES  OF  THE  TONGUE 

be  allowed  for  the  establishment  of  the  circulation  and  if  it 
does  not  occur  in  that  time,  the  affected  part  should  be 
amputated.  This  must  be  done  under  general  anesthesia. 
Fix  the  jaws  open  with  a  mouth  speculum  and  draw  the 
tongue  forward,  using  blunt  forceps  or  a  tape  suture  through 
the  healthy  tissue  to  hold  it.  A  pair  of  dull,  heavy  scissors 
can  be  used  to  remove  the  diseased  part.  A  small  ecraseur 
will  also  do.  Control  the  excessive  hemorrhage  by  twisting 
the  artery  with  forceps  or  by  ligation.  An  animal  with  part 
of  the  tongue  removed  will  have  difficulty  in  drinking,  and 
water  should  be  supplied  in  a  vessel  of  sufficient  depth  to 
allow  the  mouth  to  be  submerged  or  from  a  faucet  placed  at 
the  height  of  the  head. 


CHAPTER  IV. 
DISEASES  OF  THE  SALIVARY  GLANDS. 

Examination.— 1.  The  glands  can  be  examined  by  palpa- 
tion for:  (a)  Enlargements  (cysts,  abscesses,  tumors,  etc.); 
(6)  inflammations;  (c)  wounds;  (d)  fistulse. 

2.  The  character  and  the  amount  of  the  secretions.  The 
normal  secretion  is  a  mixture  of  secretions  from  the  parotid, 
submaxillary,  sublingual  and  the  mucous  glands  of  the  mouth. 
It  is  a  thin,  slightly  viscid,  opalescent  fluid,  having  a  feeble 
alkalin  reaction  and  a  specific  gravity  of  1005-1008. 

An  increase  in  the  salivary  secretion  is  noticed  in  the  follow- 
ing conditions:  The  different  forms  of  stomatitis;  dentition; 
chorea  by  reason  of  the  increased  masticatory  movements; 
gastric  ulcers;  nausea;  helminthiasis;  severe  pain;  direct  nerve 
stimulation  either  central  or  peripheral;  uremia;  mercurial 
poisoning;  drugs  such  as  pilocarpin  which  produce  direct 
stimulation  to  the  secretory  nerve. 

The  secretion  of  saliva  is  diminished  in  the  following 
conditions :  During  the  course  of  fevers  (pneumonia,  septic 
fever,  etc.);  after  the  use  of  atropin  or  belladonna;  fright 
and  excitement ;  severe  diarrheas ;  cirrhosis  of  the  liver  when 
ascites  is  developing;  atrophy  of  the  salivary  glands. 

PAROTITIS. 

Mumps. 

Definition. — An  acute  or  chronic  inflammation  of  the 
parotid  gland. 

Etiology.— Mechanical— Direct  injuries  to  the  gland  by 
being  run  over  by  vehicles;  struck  with  stones;  kicks,  etc.; 
pulling  back  when  tied  and  the  collar  injuring  the  gland  or 
by  being  caught  in  a  door. 

Chemical.— The  internal  administration  of  potassium  iodid 
in  too  large  doses  or  the  absorption  of  iodin  from  local  appli- 


116  DISEASES  OF  THE  SALIVARY  GLANDS 

cations  will  often  produce  it.  Lead  when  given  in  large  doses 
will  sometimes  cause  acute  parotitis  which  may  result  in  a 
chronic  induration  of  the  gland.  Inflammations  of  the 
mucous  membrane  of  the  mouth  from  chemicals  will  reflexly 
and  by  absorption  produce  an  inflammation  of  the  glands. 
Obstruction  of  the  ducts  from  chemical  action  or  from  other 
causes  of  stomatitis  often  leads  to  a  chronic  parotitis.  From 
the  retention  of  the  secretions,  the  glands  become  enlarged 
and  hard  and  may  resemble  tumor  formation. 

Infectious.— The  disease  sometimes  appears  in  the  form 
of  an  epizootic  which  no  doubt  is  caused  by  a  specific  organ- 
ism. A  diplostreptococcus  has  been  isolated  from  the  gland 
and  from  Steno's  duct  during  such  epizootics.  Other  organ- 
isms have  also  been  found  but  as  yet  none  of  them  has 
proved  specific.  During  the  course  of  infectious  diseases 
(distemper,  etc.)  the  parotid  is  frequently  infected  resulting 
in  an  acute  inflammation.  Parotitis  occurs  as  a  secondary 
disease  in  pharyngitis,  stomatitis  and  other  local  inflamma- 
tory conditions.  Chronic  parotitis  results  from  repeated 
acute  attacks  or  from  obstruction  to  the  ducts. 

Pathology.— The  acute  parotitis  in  the  early  stages  begins 
with  a  swelling,  congestion  and  serous  infiltration  of  the 
interlobular  connective  tissue.  Later  small  abscesses  develop 
which  become  confluent  forming  one  large  abscess.  In  chronic 
parotitis  there  is  a  thickening  of  the  connective  tissue  and 
atrophy  of  the  glandular  substance  which  produce  a  hard, 
fibrous  condition  (indurative  parotitis). 

Symptoms.— The  acute  infectious  parotitis  begins  with  a 
swelling  in  one  or  both  glands,  with  a  collateral  edema  in  the 
surrounding  tissues.  The  swelling  usually  develops  rapidly, 
is  very  painful  to  the  touch  and  changes  the  appearance 
of  the  head  and  neck.  The  head  is  held  away  from  the 
affected  side  or  if  bilateral  is  extended.  The  temperature 
is  elevated  (103°-105°  F.),  the  animal  shows  depression, 
partial  or  complete  loss  of  appetite,  and  mastication  is  slow 
and  careful.  The  saliva  is  usually  increased  in  quantity  and 
runs  from  the  corners  of  the  mouth  in  strands.  In  a  few 
days  abscesses  develop,  producing  a  fluctuating  enlargement 
which  discharges  reddish  colored  pus  when  opened.  In 


PAROTITIS  117 

parotitis  produced  by  injuries,  lesions  are  often  found  on 
the  skin.  In  most  cases  only  one  gland  is  affected  and  general 
disturbance  will  not  be  noted.  When  resulting  from  pharyn- 
gitis and  stomatitis,  the  symptoms  are  modified  by  the 
swelling  of  the  mucous  membrane  and  connective  tissues. 
There  is  quite  an  extensive  edema  of  the  lips,  tongue  and  in 
the  tissue  around  the  gland.  Chronic  parotitis  is  charac- 
terized by  a  firm  enlargement  of  the  gland,  acute  symptoms 
being  absent.  Steno's  duct  may  be  distended  from  a  closure 
of  the  buccal  opening. 

Diagnosis. — Acute  parotitis  may  be  confused  with  enlarge- 
ment of  the  lymph  glands  and  therefore  must  be  examined 
carefully.  The  position,  shape  and  nature  of  the  enlarge- 
ment are  to  be  considered  in  making  the  diagnosis. 

Prognosis.— Usually  favorable.  When  abscesses  develop 
a  fistula  may  result  from  the  opening  of  some  of  the  ducts. 
In  chronic  indurative  parotitis,  the  prognosis  is  less  favorable. 

Treatment.— In  the  early  stages  when  the  glands  are 
enlarged  endeavor  to  hasten  resolution,  or  abscess  formation. 
Later  a  stimulating  liniment  (soap  or  white)  may  be  used 
with  good  results.  When  abscesses  develop,  they  should 
be  opened  early  so  as  to  secure  good  drainage.  When  the 
incision  is  made,  it  should  be  only  through  the  skin,  and  the 
tissues  then  separated  with  the  fingers  in  order  not  to  injure 
the  gland  any  more  than  is  absolutely  necessary.  Irrigate 
the  cavity  daily  with  antiseptic  solutions  (boric  acid  2  per 
cent.,  etc.).  In  cases  where  the  discharge  is  persistent  and 
abundant,  tincture  of  iodin  or  Lugol's  solution  injected  into 
the  gland  gives  good  results  (see  Salivary  Fistula). 

In  chronic  parotitis  recovery  may  be  hastened  by  the 
application  of  iodin  ointment  over  the  surface  of  the  glands. 
Lugol's  solution  may  be  injected  directly  into  the  gland. 
Insert  the  needle  rather  deep  into  the  gland  substance,  being 
careful  that  it  does  not  enter  a  bloodvessel,  which  will  be 
shown  by  the  free  flow  of  blood.  Injections  may  be  made  at 
different  parts  of  the  gland  and  repeated  in  a  few  days  if 
necessary.  Small  doses  of  potassium  iodid  (0.05-0.10)  given 
once  daily  will  assist  in  the  absorption  of  the  deposits  in  the 
gland. 


118  DISEASES  OF  THE  SALIVARY  GLANDS 

SUBMAXILLARY  AND  SUBLINGUAL  GLANDS. 

These  glands  owing  to  their  position  are  not  as  often 
injured  as  the  parotid,  therefore  inflammation  due  to  trau- 
matism  is  rare.  Occasionally  infection  develops  in  the  glands 
by  gaining  entrance  through  the  ducts  and  producing  an 
acute  inflammation. 

Symptoms.— Enlargement  of  the  glands,  profuse  salivation 
with  the  head  held  extended.  Abscesses  often  form  in  the 
glands  which  open  and  discharge  a  reddish  colored  pus. 
The  opening  may  be  through  the  skin  or  into  the  mouth. 

Treatment. — See  Parotitis . 


SALIVARY  FISTULA. 

Definition.— A  fistula  which  discharges  secretions  from  the 
salivary  glands. 

Etiology.— Mechanical.— Injuries  (cuts,  bites,  etc.)  in 
which  Steno's  duct  or  any  of  the  smaller  ducts  are  opened 
so  as  to  permit  the  escape  of  saliva;  often  follows  operations 
for  the  removal  of  a  calculus  from  Steno's  duct. 

Infectious.— Abscesses  which  develop  within  the  gland 
may  rupture  and  leave  an  opening  through  which  the  saliva 
escapes. 

Pathology.— When  the  injuries  or  abscesses  open  a  duct, 
the  overlying  tissues  heal  until  there  is  only  a  small  opening 
left  through  which  the  saliva  continues  to  be  discharged.  In 
some  cases,  however,  the  healing  of  the  skin  is  complete  and 
then  the  accumulated  secretions  burrow  along  under  the 
skin.  When  there  is  enough  fluid  to  cause  necrosis  of  the 
skin  by  the  pressure,  it  opens  and  thus  forms  a  fistula.  This 
in  turn  may  heal  only  to  reopen  in  another  place.  Such 
openings  have  been  found  in  the  lumbar  region. 

Symptoms.— A  small  opening  will  be  noted  partially 
covered  with  matted  hair  and  from  which  is  discharged  a 
thin  serous  fluid  (saliva)  and  occasionally  a  small  amount 
of  pus.  When  probed,  it  will  be  found  to  be  only  subcu- 
taneous unless  in  the  region  of  the  gland  when  it  will  be 
deeper  and  lead  to  the  gland  or  duct.  A  history  of  these 


SALIVARY  FISTULA  119 

fistulse  appearing  from  time  to  time  may  extend  over  several 
months.  In  fistula  of  the  duct,  the  saliva  flows  freely  and 
increases  where  food  is  offered  or  taken. 

Diagnosis.— The  chronicity  and  the  character  of  the  dis- 
charge are  usually  sufficient  to  make  a  diagnosis. 

Prognosis. —Unfavorable. 

Treatment.— When  the  fistula  is  distant  from  the  gland, 
probe  carefully  until  the  origin  is  reached.  Open  the  skin 
at  this  point  and  apply  treatment  direct  to  the  opening  in 
the  duct  or  gland.  Tincture  of  iodin  applied  direct  to  the 
opening  leads  to  swelling  which  occludes  the  opening. 

In  obstinate  cases  the  thermocautery  should  be  used. 
When  Steno's  duct  is  open,  suturing  may  be  attempted. 
When  all  treatment  fails  complete  destruction  of  the  gland 
by  repeated  injections  of  iodin  directly  into  the  gland  or 
extirpation  should  be  practised. 


CHAPTER  V. 
DISEASES  OF  THE  TONSILS. 

Examination.— The  tonsils  can  be  readily  examined  in 
docile  animals  by  opening  the  mouth  (see  examination  of 
the  mouth)  and  pulling  the  tongue  well  forward.  In  vicious 
animals,  partial  or  complete  anesthesia  is  advisable.  The 
tonsils  should  be  examined  for  acute  or  chronic  inflamma- 
tions, deposits  of  mucus  on  their  surface,  abscess  formation, 
tumors  and  foreign  bodies.  The  adjacent  lymphatic  tissues 
are  frequently  involved  producing  a  diffuse  enlargement  of 
all  the  surrounding  parts. 

TONSILLITIS  AND  LYMPHADENITIS. 

Definition.— An  acute  or  chronic  inflammation  of  the  tonsils 
and  the  adjacent  lymphatic  tissues. 

Etiology.— Tonsillitis  is  not  of  very  frequent  occurrence. 
Some  breeds  (Boston  terrier),  however,  are  occasionally 
affected. 

Exposure  to  wet  and  cold  and  bad  hygienic  surroundings 
appear  to  have  a  direct  influence  in  producing  the  disease. 

Chemical.  —  Carbolic  acid,  arsenic,  etc.,  may  produce  it 
by  direct  irritation. 

Mechanical. — Foreign  bodies  (sharp  pieces  of  bone,  needles 
and  pins,  etc.)  often  penetrate  the  glands  and  lymph  tissue 
resulting  in  acute  inflammation.  Inflammation  of  contigu- 
ous parts  will  often  produce  the  condition  by  spread  of  the 
inflammatory  process  (stomatitis,  pharyngitis,  etc.). 

Infectious.— The  tonsils  and  lymphatic  tissues  undoubtedly 
take  up  a  lot  of  microorganisms,  the  most  common  of  which 
are  the  streptococci  and  the  staphylococci.  These  organisms 
by  their  rapid  development  in  the  tonsils  produce  an  acute 


TONSILLITIS  AND  LYMPHADENITIS  121 

inflammation,  and  from  there,  they  or  their  products  may 
enter  the  general  circulation  and  produce  symptoms  of  a 
general  infection,  or  toxemia.  Further,  this  condition  may 
appear  during  the  course  of  some  diseases,  as  distemper, 
rabies,  endocarditis,  etc. 

Pathology.— The  tonsils  and  the  lymphatic  tissues  become 
swollen,  reddened,  and  later  covered  with  a  thick,  tenacious 
mucus.  Vesicles  are  frequently  formed,  and  in  some  instances 
even  membranous  exudation,  forming  a  pseudomembrane. 
The  lacunae  of  the  tonsils  become  filled  with  a  cheesy  mass 
of  exudation,  often  becoming  confluent,  forming  small 
abscesses.  The  contents  of  the  lacunae  are  composed  of 
epithelial  debris  and  micrococci.  In  the  chronic  form,  the 
tonsils  become  hypertrophied  due  to  a  multiplication  of  the 
glands  mainly  involving  the  lymphoid;  or  in  some  instances 
the  fibrous  stroma  is  increased  and  the  tonsils  become  hard 
and  swollen. 

Symptoms.  —  In  the  early  stages  the  temperature  is 
elevated  102°-104°  F.,  respirations  and  pulse  accelerated. 
When  the  glands  become  much  enlarged,  the  patient  breathes 
with  difficulty,  holding  the  mouth  open,  producing  a  peculiar 
snoring  sound.  Direct  examination  reveals  the  reddened 
and  enlarged  tonsils.  The  cervical  lymph  glands  are  also 
frequently  enlarged  from  the  infection.  In  severe  cases  the 
tonsils  become  very  much  enlarged  forming  abscesses. 
However,  in  the  majority  of  cases  the  inflammation  subsides 
within  a  week,  the  temperature  becomes  normal,  and  the 
local,  condition  rapidly  disappears.  In  the  chronic  form  the 
symptoms  are  milder  and  are  usually  overlooked. 

Prognosis.  — In  most  cases  favorable;  depends  somewhat 
upon  the  cause.  The  course  is  rarely  longer  than  one  week 
or  ten  days  for  the  acute  form,  while  the  chronic  form  may 
continue  for  several  weeks. 

Treatment.— Locally  the  tonsils  and  the  lymph  tissues  may 
be  treated  with  a  5  per  cent,  sodium  bicarbonate  solution. 
Astringent  and  styptic  preparations  (iron,  alum,  zinc  and 
silver  nitrate)  may  be  found  useful.  Borax  in  glycerin 
(2  per  cent.)  or  thymol  in  glycerin  (3  per  cent.)  can  be  used 
as  a  deodorant  when  the  mouth  becomes  offensive.  Abscesses 


122  DISEASES  OF  THE  TONSILS 

should  be  incised  freely  to  allow  drainage  and  antiseptic 
solutions  used.  In  chronic  hypertrophy  of  the  glands  and 
lymph  tissues,  it  often  becomes  necessary  to  remove  the 
enlargement  surgically.  This  can  readily  be  done  under 
anesthesia  with  the  aid  of  a  mouth  speculum  to  fix  the  jaws 
open  when  with  a  sharp  curette  the  growths  can  quickly  be 
removed.  After-treatment  with  antiseptic  solutions  (boric 
acid  2  per  cent.)  should  be  continued  for  a  few  days. 


CHAPTER  VI. 
DISEASES  OF  THE  PHARYNX. 

Examination.— The  pharynx  is  easily  exposed  to  view  by 
opening  the  mouth  and  pulling  the  tongue  forward.  For  a 
more  careful  examination  the  mouth  speculum  may  be  used 
to  immobilize  the  jaws,  while  in  vicious  animals  it  is  always 
best  to  use  an  anesthetic. 

PHARYNGITIS. 

Pharyngitis  is  divided  into  (a)  acute,  and  (6)  chronic. 

Acute  Pharyngitis.— Definition.— An  acute  inflammation 
of  the  pharynx. 

Etiology.— Mechanical.— Sharp  foreign  bodies  (needles, 
pins,  sharp  pieces  of  bone,  etc.)  may  penetrate  the  mucous 
membrane  and  produce  an  acute  local  inflammation. 

Chemical.— Inhalation  of  gases  (smoke,  ammonia,  etc.) 
will  produce  inflammation  in  the  pharynx  as  wrell  as  in  the 
larynx.  Drugs  administered  in  concentrated  form. 

Thermic.— Very  hot  liquids  or  foodstuffs  when  swallowed 
frequently  produce  in  dogs  a  severe  pharyngitis.  Exposure 
to  cold  when  the  body  is  heated  will  produce  a  congestion 
in  the  pharyngeal  mucous  membrane  and  this  may  result 
in  an  acute  pharyngitis. 

Infectious.— Many  of  the  above  causes  predispose  to  infec- 
tion, the  most  common  of  which  are  produced  by  the  strepto- 
coccus and  the  Bacillus  necrophorus.  A  severe  form  of 
infectious  pharyngitis  is  occasionally  seen  in  week -old 
puppies  and  kittens,  in  some  cases  amounting  almost  to  an 
enzootic,  affecting  the  entire  litter.  Pharyngitis  is  secondary 
to  infectious  diseases  as  rabies,  distemper,  infectious  nasal 
catarrh  and  cholera  of  birds.  It  is  often  produced  by  an 
extension  of  inflammation  from  the  adjacent  organs  and 
tissues  (nasal  catarrh,  bronchitis,  stomatitis,  etc.). 


124  DISEASES  OF  THE  PHARYNX 

Pathology.  — (a)  Acute  pharyngitis  is  characterized  by 
redness  and  swelling  of  the  mucous  membrane  which  has  a 
glazed  appearance  due  to  the  collection  of  mucus  on  the 
surface.  Later  there  is  an  abundant  discharge  of  a  thick 
mucus  or  a  mucopurulent  exudate.  Occasionally  it  may  be 
tinged  with  blood.  In  severe  cases  small  erosions  appear  on 
the  posterior  part  of  the  pharynx.  The  lymph  follicles  are 
enlarged  and  appear  as  small,  round,  elevated,  reddish 
nodules  projecting  through  the  membrane. 

(6)  The  discharge  contains  bacteria,  leukocytes,  blood 
cells  and  desquamated  and  degenerated  epithelium. 

Symptoms.— One  of  the  first  symptoms  is  difficulty  in 
swallowing  food.  Frequent  attempts  at  swallowing  with  the 
head  extended  are  often  noticed  in  the  early  stages.  Later, 
in  the  more  severe  cases,  abundant  salivation  results  from 
increased  secretion. and  inability  to  swallow,  while  retching 
and  sometimes  vomiting  will  be  seen  in  some  cases  from  the 
irritation.  The  head  is  usually  held  extended  and  palpation 
of  the  pharynx  produces  pain.  The  submaxillary  and  retro- 
pharyngeal  lymph  glands  often  become  enlarged  and  may 
produce  abscesses.  Occasionally  in  severe  cases  the  salivary 
glands  become  involved.  On  examination  of  the  pharynx 
the  mucous  membrane  will  be  found  reddened,  congested, 
and  covered  with  mucus  or  mucopurulent  exudate,  depending 
upon  the  stage  of  the  development  of  the  disease,  and  in 
severe  cases  swelling  and  congestion  of  the  adjacent  tissues. 
Cough  is  absent  and  only  occurs  when  the  inflammatory 
process  extends  to  the  larynx.  In  all  cases  where  infection 
develops,  the  temperature  is  elevated  (103°-105°  F.).  In 
mild  cases  when  the  general  symptoms  are  absent,  the  appe- 
tite remains  good  although  the  animal  takes  food  slowly  and 
with  care.  In  severe  cases  there  is  a  complete  loss  of  appetite. 

Diagnosis.— The  symptoms  of  acute  pharyngitis  are  very 
characteristic:  The  extended  head,  difficult  swallowing  and 
salivation;  while  direct  examination  and  the  temperature 
readily  distinguish  it  from  foreign  bodies,  tumors  and  par- 
alysis of  the  pharynx. 

Prognosis.— In  older  animals  it  is  favorable,  recovery 
occurring  in  one  to  two  weeks.  In  young  animals,  when  it 
occurs  as  an  cnzootic,  the  mortality  is  high. 


PHARYNGITIS  125 

Treatment.— Dietetic.— Soft  liquid  foods  (rice  soup,  milk, 
extract  of  beef,  etc.)  should  be  given  in  preference  to  solids 
to  avoid  irritating  the  mucous  membrane. 

Medical.— Local  treatment  in  the  form  of  astringent  and 
antiseptic  solutions  (2  per  cent,  silver  nitrate  solution;  5 
per  cent,  alum  solution;  iodin  and  glycerin  1-30)  applied 
directly  to  the  membrane  by  using  a  pledget  of  cotton  held  in 
dressing  forceps.  In  milder  cases  a  solution  of  potassium 
chlorate  (2  per  cent.)  or  iron  sulphate  in  the  drinking  water 
is  recommended.  A  Priesnitz  compress  applied  over  the 
pharynx  and  followed  with  mild  stimulating  liniments 
(soap  liniment,  etc.)  is  often  beneficial.  Internally  mild 
purgatives  such  as  castor  oil  or  cascara  should  be  used. 

Chronic  Pharyngitis.— Definition.— A  chronic  inflammation 
of  the  mucous  membrane  of  the  pharynx. 

Etiology.— This  condition  may  follow  repeated  acute  at- 
tacks, or  is  frequently  associated  with  chronic  nasal  catarrh. 
It  also  occurs  secondary  to  inflammation  of  adjacent  tissues. 
Dogs  constantly  barking  from  a  nervous  temperament  or 
during  shows  are  often  affected  from  the  spread  of  the 
inflammation  from  the  larynx. 

Pathology. — The  mucous  membrane  is  relaxed,  the  lymph 
tissue  becomes  proliferated  forming  small,  round  elevations, 
red  or  bluish-red  in  color  which  project  above  the  surface 
of  the  membrane,  and  is  known  as  pharyngitis  granulosa. 
The  secretions  are  lessened  producing  a  dry,  glistening  con- 
dition of  the  pharyngeal  mucosa. 

Symptoms.— The  symptoms  are  similar  in  many  respects 
to  those  of  acute  pharyngitis,  but  milder  in  most  cases.  The 
swelling  of  the  adjacent  tissues  and  lymph  glands  is  hardly 
noticeable.  The  difficulty  in  swallowing  is  especially  marked 
when  a  large  quantity  of  food  is  taken  or  when  the  food  is 
very  hot  or  very  cold.  Direct  examination  of  the  pharynx 
reveals  the  bluish-red  color  and  the  elevations  over  its  surface. 

Prognosis.— Considered  favorable  in  most  cases,  depending 
somewhat  on  the  possibility  of  removing  the  causes.  In  the 
milder  cases  it  is  very  often  overlooked. 

Treatment.— Direct  application  of  Lugol's  solution  to  the 
mucous  membrane  has  been  found  useful  in  most  cases. 


126  DISEASES  OF  THE  PHARYNX 

Tannic  acid  and  glycerin  (1-30)  may  also  be  used.  Chlorid 
of  iron  (1-10)  in  water  is  of  value  owing  to  its  astringent  and 
antiseptic  qualities.  The  application  of  the  preparations 
should  be  made  daily  until  the  symptoms  subside. 

FOREIGN  BODIES  IN  THE  PHARYNX. 

Foreign  bodies  may  find  lodgment  in  the  mouth  or  in  the 
pharynx.  When  dogs  are  ravenously  hungry  large  particles 
of  food  or  food  containing  foreign  bodies  are  swallowed  which 
may  lodge  in  the  pharynx,  producing  choking.  The  condi- 
tion often  terminates  fatally  in  a  short  time.  Cats  when  fed 
on  fish  are  liable  to  have  fish  bones  lodge  in  the  pharynx. 
These  bones  frequently  penetrate  the  mucosa,  producing  an 
edema  of  the  pharynx  and  larynx,  resulting  in  death  from 
asphyxia.  Birds,  when  eating  large  seeds  (sunflower  seeds, 
corn,  etc.)  often  have  them  lodge  in  the  pharynx,  producing 
serious  symptoms.  Various  kinds  of  foreign  bodies  have 
been  found  in  the  pharynx,  the  most  common  being  needles, 
pins,  bones,  hard  food  masses,  meat  skewers,  cartilage,  etc. 

Symptoms.— The  symptoms  vary  somewhat  according  to 
the  size  and  character  of  the  foreign  body.  Dribbling  of 
saliva  from  the  corners  of  the  mouth;  frequent  attempts  at 
swallowing;  clawing  at  the  mouth  with  the  forefeet,  and 
sometimes  retching  and  vomiting.  When  the  foreign  bodies 
are  large  they  often  interfere  with  the  respirations. 

Diagnosis.— The  diagnosis  is  made  by  direct  examination 
of  the  pharynx  (see  examination  of  the  pharynx),  the  sudden 
development  and  the  characteristic  symptoms. 

Prognosis.— Depends  upon  the  size  and  character  of  the 
foreign  body.  Where  the  foreign  bodies  are  small  and  the 
animal  can  be  treated  at  once,  the  prognosis  is  favorable.  In 
other  cases  where  edema  occurs  or  where  the  foreign  body  is 
quite  large,  death  may  terminate  before  assistance  can  be 
given. 

Treatment.— Surgical.— A  mouth  speculum  is  used  to  keep 
the  mouth  open  and  the  foreign  body  often  can  be  easily 
removed  with  a  long  curved  throat  forceps.  Holding  the 
tongue  well  forward  will  materially  assist  in  locating  accu- 


CROUPOUS  PHARYNGITIS  OF  BIRDS  127 

rately  the  foreign  body.  When  the  foreign  body  is  in  the  form 
of  a  threaded  needle,  which  frequently  occurs  in  cats,  the 
sharp  point  is  usually  toward  the  mouth.  Therefore  care 
should  be  used  in  removing  it  to  prevent  laceration  of  the 
tissues.  By  grasping  it  with  the  forceps  and  pushing  it  down- 
ward until  the  sharp  point  is  free  from  the  tissues,  it  can  then 
be  readily  removed.  Large  food  masses  often  can  be  broken 
between  the  fingers  and  extracted  or  pushed  down  into  the 
esophagus.  Where  edema  of  the  tissues  results  from  lacera- 
tion and  symptoms  of  suffocation  develop,  tracheotomy 
should  be  performed  at  once.  (See  Tracheotomy.)  No 
after-treatment  is  necessary  except  when  severe  injury  to 
the  tissues  has  taken  place ;  in  these  conditions  the  pharynx 
should  be  treated  direct  with  antiseptic  solutions  (boric  acid 
2  per  cent.),  using  a  dressing  forceps  with  a  pledget  of  cotton 
firmly  attached.  In  birds  the  mouth  is  held  open  and  a 
small  pincette  used  to  dislodge  the  foreign  body. 

PARALYSIS  OF  THE  PHARYNX. 

Pharyngeal  paralysis  occurs  mostly  during  the  course  of 
specific  diseases  (rabies,  distemper)  and  will  therefore  be 
described  under  those  diseases  which  it  accompanies. 

CROUPOUS  PHARYNGITIS  OF  BIRDS. 

Definition.— A  croupous  inflammation  affecting  the  pharyn- 
geal  mucous  membrane  of  birds. 

Etiology.— This  condition  is  produced  by  a  flagellated 
infusoria,  the  Monocercomonas  gallinse.  This  parasite  is 
round  or  discoid  in  shape,  of  a  pale  color  and  from  14  to  25 
mm.  in  length  and  5  to  7  mmm.  in  breadth.  The  disease 
affects  young  birds,  especially  pigeons.  Unsanitary  condi- 
tions and  cold,  damp  quarters  are  predisposing  factors. 

Pathology.— Small  white  elevations  are  found  on  the 
mucous  membrane  of  the  pharynx,  often  extending  into  the 
esophagus  and  crop.  Occasionally  these  lesions  are  noted 
at  the  base  of  the  tongue  and  on  the  palate.  Surrounding 
these  small  elevations  are  found  zones  of  acute  inflammations 
with  considerable  swelling  and  congestion  of  the  membrane. 


128  DISEASES  OF  THE  PHARYNX 

Symptoms.— Loss  of  appetite,  dulness  and  general  weakness 
are  the  first  symptoms  observed.  The  plumage  becomes 
rough,  the  wings  are  pendant  and  the  mouth  held  open. 
The  odor  from  the  mouth  is  offensive.  Examination  of  the 
posterior  part  of  the  mouth  and  the  pharynx  reveals  the 
presence  of  the  small  white  elevations.  A  microscopic  exami- 
nation of  scrapings  made  from  these  white  spots  will  confirm 
the  diagnosis  by  finding  the  infusoria. 

Prognosis.— It  should  be  considered  unfavorable  especially 
in  very  young  birds.  Death  occurs  in  many  cases  from  loss 
of  appetite  and  exhaustion. 

Treatment.— Where  only  a  few  cases  are  observed,  they 
should  be  separated  at  once  from  the  healthy  birds  and  the 
runways  and  roosts  thoroughly  disinfected  with  lime,  or 
carbolic  acid  (5  per  cent.).  The  mouth  and  pharynx  should 
be  cleansed  with  a  solution  of  boric  acid  (2  per  cent.)  or 
creolin  to  destroy  the  infusoria.  Remove  the  small  elevations 
with  a  blunt  curette  and  apply  to  the  surface  chlorid  of  iron 
(1-10)  in  water  or  a  solution  of  tannic  acid  (5  per  cent.)  in 
water,  to  arrest  the  hemorrhage  and  to  produce  antiseptic 
action. 

NEOPLASMS  OF  THE  PHARYNX. 

Polypoid  Growths.— Polypoid  growths  (myxomas)  are 
found  occasionally  projecting  from  the  pharyngeal  mucous 
.membrane.  They  vary  greatly  in  size  from  half  an  inch  to 
four  inches  in  length.  From  severe  or  sudden  exertion  or 
swallowing  they  are  often  forced  into  the  esophageal  opening, 
interfering  with  the  prehension  of  food  and  drink. 

Symptoms.— Sudden  interference  with  deglutition;  symp- 
toms of  suffocation ;  often  rapid  recovery ;  periodic  recurrence 
of  the  symptoms  and  direct  examination  of  the  pharynx  will 
reveal  the  presence  of  the  polypoid  growths. 

Treatment.  —  Surgical.— The  mouth  speculum  should  be 
used,  the  tongue  pulled  well  forward  and  a  small  wire  ecraseur 
used  to  remove  the  enlargement.  It  should  be  removed  as 
close  to  the  base  as  possible.  No  after-treatment  is  necessary. 
Recovery  takes  place  promptly. 


NEOPLASMS  OF   THE  PHARYNX  129 

Epithelioma.  —  These  are  found  occasionally  in  old  animals, 
and  occur  in  the  pharynx  as  a  primary  condition  or  may  he  due 
to  metastasis.  The  retropharyngeal  and  submaxillary  lymph 
glands  are  nearly  always  involved.  This  condition  has  been 
seen  secondary  to  malignant  goiter,  having  extended  to  the 
lymph  glands  by  metastasis  and  from  there  to  the  pharynx. 

Symptoms.— Difficulty  in  swallowing;  fetid  odor  from  the 
mouth;  often  profuse  salivation.  Direct  examination  shows 
the  presence  of  an  ulcerated  enlargement  on  the  pharyngeal 
mucosa.  The  general  condition  is  in  most  cases  disturbed. 
Emaciation,  especially  when  due  to  metastasis;  loss  of  appe- 
tite. A  small  portion  of  the  enlargement  should  be  obtained 
and  examined  microscopically  to  confirm  the  diagnosis. 

Treatment.— No  satisfactory  treatment  can  be  given. 


CHAPTER  VII. 
DISEASES  OF  THE  ESOPHAGUS. 

Examination.— The  cervical  portion  of  the  esophagus  is 
readily  examined  by  palpation  over  its  course  along  the 
upper  surface  of  the  trachea.  The  probang  affords  a  means 
of  examining  the  interior  for  foreign  bodies,  strictures,  etc., 
along  its  entire  length. 

ESOPHAGITIS. 

Definition.— An  acute  inflammation  of  the  mucous  mem- 
brane of  the  esophagus. 

Etiology.— (a)  Mechanical. — Irritation  from  foreign  bodies 
(bones,  needles,  splinters  of  wood,  etc.),  passing  of  sounds, 
etc.,  lacerating  the  mucous  membrane.  External  injuries  to 
walls. 

(6)  Thermic. — Eating  very  hot  foodstuffs  or  drinking  hot 
liquids. 

(c)  Chemical.— Alkalies  and  acids,  ammonia  and  corrosive 
medicinal  agents  frequently  in  their  passage  through  the 
esophagus  produce  an  acute  inflammation. 

(d)  Infectious. — Occurs  during  the  course  of  infectious 
diseases  (rabies,  distemper). 

Secondarily  it  is  produced  by  the  spread  of  the  inflamma- 
tion from  the  pharynx  or  stomach.  It  occurs  sometimes 
spontaneously  in  very  young  suckling  animals. 

Pathology.— Redness  of  the  mucosa  is  rarely  seen  except 
after  injuries  or  severe  chemical  irritants.  The  epithelium 
is  thickened,  desquamated  and  the  surface  covered  with  a 
fine  granular  substance.  The  mucous  follicles  are  swollen 
and  sometimes  erosions  may  be  seen.  In  phlegmonous 
inflammation,  the  mucous  membrane  is  swollen,  with  a 


FOREIGN  BODIES— OBSTRUCTION  IN  ESOPHAGUS    131 

purulent  infiltration  in  the  submucosa.  This  condition  is 
usually  seen  around  foreign  bodies  when  they  penetrate  the 
membranes,  and,  as  a  rule,  remains  localized.  Gangrene  of 
the  membrane  is  sometimes  seen  where  the  injury  or  infec- 
tion has  been  severe. 

Symptoms.— In  the  milder  forms  of  esophagitis  the  symp- 
toms are  unobserved.  In  more  severe  forms  there  is  great 
difficulty  in  swallowing  which  act  is  often  soon  followed  by 
vomiting.  The  vomitus  contains  blood,  the  solid  particles 
covered  or  streaked  with  it.  Frequent  attempts  at  swallow- 
ing, constantly  extending  the  head  or  moving  it  from  side 
to  side.  In  some  cases  where  corrosives  have  been  swallowed 
fragments  of  the  mucous  membrane  will  be  ejected  with  the 
vomitus.  Profuse  salivation,  blood  is  often  mixed  with  the 
saliva.  Palpation  along  the  cervical  portion  of  the  esophagus 
produces  severe  pain. '  When  localized  in  the  cervical  por- 
tion the  esophagus  should  be  palpated  carefully  for  foreign 
bodies. 

Course  and  Prognosis.— In  the  majority  of  cases,  recovery 
takes  place  in  one  to  two  weeks.  In  very  severe  inflammation 
complications  are  liable  to  occur.  Strictures  or  abscess  with 
perforation  of  the  walls  of  the  esophagus  may  result.  In  the 
latter  when  the  thoracic  portion  is  involved  the  termination 
is  fatal  from  infectious  pleuritis. 

Treatment.— In  the  early  stages  cold  milk,  or  tannic  acid 
(1-2  per  cent.)  in  cold  water  is  indicated  to  allay  the  inflam- 
mation and  to  produce  astringent  action.  Cold  compresses 
to  the  cervical  portion  of  the  esophagus  often  have  a  beneficial 
action.  Inflammations  from  caustic  substances  should  be 
treated  as  early  as  possible  with  the  proper  antidote.  When 
severe  pain  is  shown  small  doses  of  morphin  should  be  admin- 
istered subcutaneously.  Tincture  of  opium  in  dilute  solution 
may  be  given  per  orem.  In  very  severe  cases  where  foods 
cannot  be  given  via  the  mouth,  enemata  should  be  employed. 

FOREIGN  BODIES.     OBSTRUCTION  IN  ESOPHAGUS. 

Etiology.— Obstruction  in  the  esophagus  occurs  most  fre- 
quently in  dogs.  The  body 'lodges  immediately  posterior  to 


132  DISEASES  OF  THE  ESOPHAGUS 

the  pharynx;  at  the  lower  extremity  of  the  cervical  portion 
at  its  entrance  to  the  thorax;  or  near  the  cardiac  orifice  (at 
this  point  the  lumen  of  the  esophagus  is  less  than  at  any 
other  place  along  its  course).  Owing  to  the  habit  of  these 
animals  of  taking  food  in  large  pieces  and  without  mastica- 
tion the  majority  of  the  obstructions  occur  just  posterior  to 
the  pharynx.  However,  sharp  bodies  may  be  found  anywhere 
along  its  course.  In  the  dog  a  great  variety  of  substances 
have  been  found  producing  the  obstruction,  as  these  animals 
during  eating  or  at  play  swallow  many  substances  that  would 
not  be  found  in  other  animals.  The  most  common  substances 
which  are  liable  to  produce  the  obstruction  in  dogs  are: 
Bones,  cartilage,  hard  food  masses,  pieces  of  tendon,  needles, 
rubber  balls,  meat  skewers,  stones,  etc.  In  cats  fish  bones 
are  frequently  found  which  they  get  from  eating  scraps  of 
fish  given  them  without  removing  the  bones.  As  a  rule  fish 
bones  lodge  in  the  anterior  portion  of  the  esophagus  just 
behind  the  pharynx.  Young  kittens  while  playing  occa- 
sionally attempt  to  swallow  threaded  needles,  or  pins  which 
lodge  at  some  point  along  the  esophageal  wall.  Large  bodies 
when  indefinitely  retained  often  produce  a  pressure  necrosis 
with  perforation  of  the  walls. 

Symptoms.— The  early  symptoms  are  those  of  refusing 
food,  pain  during  swallowing,  paroxysms  of  choking  with 
retching  and  in  some  cases  vomiting,  salivation,  and  scratch- 
ing at  the  mouth  and  neck.  The  head  is  held  extended,  the 
respirations  become  labored,  and  the  patient  evinces  severe 
pain.  In  cats  the  mouth  is  held  open,  there  is  profuse  saliva- 
tion, and  when  the  foreign  body  has  penetrated  the  walls 
severe  nervous  symptoms  are  produced.  The  foreign  body 
when  located  in  the  cervical  portion  of  the  esophagus  will  at 
once  be  recognized  by  the  painful  swelling  which  appears 
along  its  course,  especially  in  the  case  of  large  objects.  There 
is  frequently  edema  of  the  surrounding  tissues  which  may 
extend  for  some  distance  from  the  point  of  injury.  Palpation 
usually  reveals  the  size  and  character  of  the  obstruction. 
Often  when  the  objects  are  located  just  posterior  to  the 
pharynx  by  opening  the  mouth  and  pulling  the  tongue  well 
forward  they  can  be  seen  or  felt  with  the  finger.  In  cats, 


FOREIGN  BODIES— OBSTRUCTION  IN  ESOPHAGUS     133 

needles  and  fish  bones  are  often  seen  by  this  method.  In  cases 
of  small  obstructions  located  in  the  thoracic  portion  of  the 
esophagus,  the  symptoms  are  not  so  pronounced.  Loss  of 
appetite,  emaciation  and  occasional  vomiting  are  the  most 
prominent  manifestations  of  the  condition.  However,  when 
sharp  objects  penetrate  the  walls  at  this  point,  various  com- 
plications of  a  serious  nature  may  be  produced.  The  passage 
of  a  sound  (horse  catheter)  is  often  a  valuable  aid  in  arriving 
at  a  correct  diagnosis.  In  valuable  animals,  Roentgen  rays 
may  be  used  to  assist  in  locating  hard  or  metallic  substances. 

Diagnosis. — This  is  made  positive  by  a  careful  examination 
together  with  the  above  mentioned"  symptoms.  Care  should 
be  taken  to  exclude  rabies  as  the  symptoms  are  similar.  (See 
Rabies.)  Always  beware  of  the  dog  with  "bone  in  the 
throat." 

Prognosis. — Foreign  bodies  located  in  the  cervical  portion 
of  the  esophagus  can  usually  be  removed  which  is  followed 
by  rapid  recovery  except  in  those  cases  where  necrosis  is 
produced  from  pressure  upon  the  walls,  or  extensive  phleg- 
monous  inflammation  from  perforation.  It  sometimes 
happens  that  needles  and  pins  will  penetrate  the  walls  and 
become  encapsuled  in  the  adjacent  tissues  without  producing 
any  further  disturbance  to  the  animal.  Foreign  bodies 
located  in  the  thoracic  portion  of  the  esophagus  should  always 
be  considered  unfavorable  owing  to  their  location  and  the 
danger  of  injury  to  the  organs  in  the  thoracic  cavity  or  a 
purulent  pleuritis  resulting  from  perforation. 

Treatment.— Obstructions  to  the  esophagus  are  removed 
by:  (a)  Use  of  throat  forceps;  (b)  by  propulsion  with  the 
sound  into  stomach;  (c)  by  emesis;  (d)  by  esophagotomy; 
(e)  by  gastrotomy  and  sound  forcing  the  foreign  body  out 
via  mouth. 

(a)  The  throat  forceps  can  often  be  used  to  an  advantage 
when  the  object  is  located  in  the  posterior  part  of  the 
pharynx  or  in  the  anterior  part  of  the  esophagus.  The  mouth 
is  held  open  with  the  speculum,  the  tongue  pulled  well  for- 
ward, and  the  object  grasped  with  the  forceps  and  removed. 
Care  should  be  taken  to  prevent  laceration  of  the  tissues  in 
case  of  a  sharp  object  or  one  of  an  irregular  shape. 


134  DISEASES  OF   THE  ESOPHAGUS 

(6)  The  sound  is  to  be  used  in  those  cases  where  the 
obstruction  is  located  farther  down  the  tube  and  cannot  be 
reached  with  the  throat  forceps.  Various  kinds  of  instru- 
ments have  been  devised  for  this  purpose.  The  horse  catheter 
will  answer  in  a  large  number  of  cases.  It  is  introduced  by 
using  the  mouth  speculum,  depressing  the  tongue.  Having 
oiled  the  instrument,  it  is  passed,  holding  it  firmly  against 
the  roof  of  the  mouth  and  following  the  posterior  wall  of  the 
pharynx,  into  the  esophagus.  When  the  instrument  reaches 
the  pharynx  the  animal  will  invariably  swallow,  which 
greatly  assists  in  its  introduction  into  the  esophagus.  The 
sound  is  then  brought  in  contact  with  the  object  which  is 
carefully  pushed  into  the  stomach.  When  there  is  much 
resistance  and  the  object  is  firmly  fixed,  the  catheter  should 
be  removed  and  other  methods  used  to  dislodge  it.  The 
bristle  probang  is  often  used  to  advantage  in  extracting 
foreign  bodies  which  do  not  entirely  close  the  lumen  of  the 
esophagus.  It  is  introduced  closed  so  that  it  may  pass  the 
object,  and  then  opened  so  that  the  bristles  will  completely 
fill  the  lumen  when  it  is  withdrawn  bringing  the  foreign  body 
out  in  front  of  it. 

(c)  The  act  of  vomiting,  which  is  easily  induced,  will  often 
displace  the  foreign  body.    This  is  best  brought  about  by 
the  use  of  apomorphin  (dogs  0.0016-0.006;  cats  0.001-0.003). 
The  administration  of  castor  or  linseed  oil  to  lubricate  the 
mucous  membrane  will  often  assist  in  removing  the  obstruc- 
tion. 

(d)  Esophagotomy  is  performed  in  the  following  man- 
ner:    Secure  the  animal  in  the  dorsal  position  with  the 
head  extended.     Clip  and  shave  the  hair  over  the  field 
of  operation  and  cleanse  thoroughly  with  antiseptic  solu- 
tions (bichlorid  of  mercury  1-2000;  boric  acid  2  per  cent., 
etc.).    Under  general  anesthesia,  using  morphin  (0.016-0.21), 
ether,  etc.,  make  a  skin  incision  over  the  obstructing  body 
and  between  the  muscles,  being  careful  to  avoid  the  large 
vessels  of  the  neck.    When  the  esophagus  is  exposed  make 
a  longitudinal  incision  through  it  of  sufficient  length  to  allow 
the  foreign  body  to  be  removed.    Care  should  be  used  to  pre- 
vent laceration  of  the  mucous  membrane.    W7hen  the  incision 


STRICTURE  OF   THE  ESOPHAGUS  135 

is  very  long,  one  or  more  interrupted  sutures  should  be  made 
in  the  esophagus  and  the  wound  packed  with  gauze  saturated 
in  a  boric  acid  solution  (2  per  cent.),  retained  with  sutures 
through  the  skin.  Allow  this  to  remain  in  position  for 
twenty-four  to  forty-eight  hours,  then  remove  pack,  the 
sutures  in  the  esophageal  wall  and  treat  as  an  open  wound, 
cleansing  it  daily  with  boric  acid  solution  (2  per  cent.)  until 
healing  is  complete.  Withhold  all  food  and  drink  for  twenty- 
four  hours  and  then  give  only  liquid  foods  for  a  few  days. 
Rectal  feeding  of  milk,  eggs,  etc.,  may  be  used  when  the 
swelling  of  the  mucous  membrane  is  sufficient  to  obstruct 
the  esophagus. 

(e)  As  a  last  resort  when  the  firmly  fixed  object  is  located 
in  the  thoracic  portion  of  the  esophagus  and  cannot  be 
removed  by  the  methods  mentioned,  gastrotomy  should  be 
performed  (see  Diseases  of  Stomach),  and  the  catheter 
introduced  to  propel  the  foreign  body  out  via  the  mouth. 
Should  the  object  be  located  in  the  cardiac  portion  of  the 
esophagus,  a  small  dressing  forceps  is  often  useful  to  grasp  it 
and  remove  it  via  stomach  incision. 

ESOPHAGISMUS. 

Definition.— A  spasmodic  contraction  of  the  esophagus. . 

Etiology.— This  condition  occurs  occasionally  during  the 
course  of  some  diseases.  It  has  been  observed  in  chorea, 
epilepsy  and  in  the  early  stages  of  rabies.  Sometimes  foreign 
bodies,  by  irritating  the  membranes,  produce  a  spasmodic 
contraction  of  the  walls  of  the  esophagus. 

Symptoms.— Very  similar  to  foreign  bodies  in  the  esophagus; 
often  foreign  bodies  are  also  present. 

Prognosis. — In  most  cases  favorable. 

Treatment.— The  passage  of  the  sound  is  usually  sufficient 
to  overcome  the  condition  except  in  the  case  of  foreign  bodies 
being  present.  (See  Foreign  Bodies  in  the  Esophagus.) 

STRICTURE  OF  THE  ESOPHAGUS. 

Definition.— A  constriction  of  the  esophagus  due  in  most 
cases  to  cicatricial  contraction  of  the  walls  reducing  the  size 
of  the  lumen. 


136  DISEASES  OF   THE  ESOPHAGUS 

Etiology.— The  most  common  causes  of  this  condition  are 
the  following:  (a)  Cicatricial  contraction  of  healed  ulcers, 
usually  due  to  corrosive  poisons;  injuries  by  foreign  bodies, 
etc. ;  esophagotomy .  (6)  External  pressure  by  enlarged  lymph 
glands,  enlarged  thyroids,  other  tumors  and  occasionally 
pericardial  effusion,  (c)  The  growth  of  tumors  in  the  walls 
of  the  esophagus  (metastatic  sarcomas  and  carcinomas). 
The  stricture  may  occur  in  any  part  of  the  esophagus,  and 
in  severe  cases  may  involve  the  entire  tube,  but  usually  it  is 
found  either  near  the  pharynx  or  the  stomach. 

Symptoms.— Difficulty  in  swallowing  and  only  small 
quantities  taken.  Severe  pain  immediately  after  eating. 
Retching  and  vomiting  are  often  noticed.  Gradual  emacia- 
tion due  to  the  interference  with  deglutition.  Examination 
of  the  esophagus  in  the  cervical  region  by  palpation  or  the 
passage  of  the  sound  to  the  thoracic  region  will  usually  reveal 
the  constricted  condition  of  the  esophagus. 

Prognosis.— Should  be  considered  unfavorable  in  all  cases 
of  long  standing.  Recent  cases,  depending  upon  the  cause, 
may  recover  sufficiently  not  to  interfere  much  with  the 
animal's  general  condition. 

Treatment.— By  surgical  means  the  cause  of  the  condition 
should  be  removed  if  possible.  The  passage  of  the  sound, 
well  lubricated,  daily  for  a  time  will  in  some  cases  overcome 
the  constriction.  In  severe  constrictions  where  a  large  por- 
tion of  the  walls  is  involved  no  treatment  can  be  applied  that 
will  be  of  any  service. 

DILATATIONS  AND  DIVERTICULA  OF  THE  ESOPHAGUS. 

Definition.— Dilatation  is  a  diseased  condition  whereby 
the  lumen  of  the  esophagus  is  enlarged  (ectasia  oesophagi). 
A  diverticulum  is  a  saccular  distention  of  the  esophageal  wall 
at  a  given  point  along  its  course  (diverticulum  oesophagi). 

Etiology. — Dilatation  may  develop  secondary  to  stenosis  of 
the  esophagus,  from  pressure  of  food  masses  retained  above 
the  stenosis  resulting  in  paralysis  or  atony  of  .the  muscular 
wall;  from  foreign  bodies  remaining  in  the  esophagus  for 
sufficient  length  of  time  to  produce  paralysis;  injuries; 


CATARRH  OF   THE  CROP  IN  BIRDS— SOFT  CROP     137 

esophagotomy.  Diverticula  may  result  from  overdistention 
of  the  esophagus  with  rupture  of  the  muscles  allowing  the 
mucous  membrane  to  protrude;  also  due  to  cicatricial  con- 
tractions following  inflammatory  adhesions  to  lymph  glands. 

Symptoms.— An  enlargement  will  be  noticed  along  the 
region  of  the  esophagus  if  it  be  in  the  cervical  portion.  Diffi- 
culty in  swallowing;  saliva  increased;  regurgitation  of  small 
amounts  of  undigested  and  decomposed  food  covered  with 
mucus;  fetid  odor  from  the  mouth;  the  probang  may  pass 
without  difficulty  although  it  may  be  obstructed  by  the 
stenosis  or  stricture  at  the  distal  end.  The  symptoms  of  a 
diverticulum  are  very  obscure  except  when  large  and  in  the 
cervical  portion  of  the  esophagus.  The  retention  of  food 
gives  rise  to  retching  and  vomiting,  or  from  the  ensuing 
ulceration  may  result  in  the  formation  of  a  fistula. 

Diagnosis.— Careful  observation  of  the  symptoms;  the 
absence  of  gastric  secretions  in  the  vomitus;  palpation 
reducing  the  enlargement  which  will  become  refilled  after 
feeding.  The  use  of  the  probang  may  assist  in  the  diagnosis 
by  determining  the  presence  of  the  stenosis  or  spasm . 

Prognosis.— Diffuse  dilatation,  or  a  diverticulum  of  the 
thoracic  portion  of  the  esophagus,  should  be  considered 
incurable.  The  prognosis  depends  upon  the  completeness 
with  which  nutrition  can  be  carried  on.  It  is  always  unfavor- 
able as  there  is  a  tendency  to  ulceration  and  perforation  of  the 
walls  with  formation  of  a  fistula. 

Treatment.— No  satisfactory  treatment  can  be  given  except 
in  diverticulum  in  the  cervical  portion  of  the  esophagus 
which  may  be  operated  (see  Esophagotomy)  and  the  diver- 
ticulum reduced  by  suturing. 

CATARRH  OF  THE  CROP  IN  BIRDS.     SOFT  CROP. 

Definition.— A  catarrhal  inflammation  of  the  mucous  mem- 
brane of  the  crop. 

Etiology.— Irregular  feeding  is  a  common  causative  factor. 
Birds  fed  irregularly  are  quite  liable  to  overload  the  crop, 
resulting  in  distention  and  partial  paralysis  of  the  muscular 
walls.  This  condition  interferes  with  the  secretion  of  the 


138  DISEASES  OF   THE  ESOPHAGUS 

glands  resulting  in  fermentation  or  decomposition  of  the  crop 
contents  which  irritate  the  mucous  membrane  often  pro- 
ducing a  severe  catarrhal  inflammation.  Elating  indigestible 
or  decomposed  substances  (feathers,  putrid  meat,  etc.)  often 
produces  catarrh  of  the  crop. 

Poisons  (arsenic,  phosphorous,  salt,  etc.),  when  taken  acci- 
dentally or  given  intentionally,  often  produce  a  very  severe 
form  of  the  disease.  The  presence  of  parasites  (Dispharagus 
nasutus,  etc.)  in  the  crop  will  in  most  cases  produce  a  catarrhal 
inflammation,  the  severity  of  which  depends  upon  the  num- 
ber present.  In  pigeons  fermentation  of  an  overabundant 
secretion  after  the  loss  of  the  young  will  produce  a  serious 
catarrhal  inflammation  of  the  crop  and  other  parts  of  the 
digestive  tract.  Crop  catarrh  also  occurs  during  the  course 
of  some  diseases  (diphtheria,  thrush,  cholera). 

Symptoms.— Distention  of  the  crop  is  at  first  the  most 
noticeable  symptom.  On  palpation  the  crop  will  be  found 
to  be  soft  and  fluctuating,  due  to  an  accumulation  of  liquid, 
gaseous  and  solid  food  material.  Loss  of  appetite,  eructations 
of  gases,  sometimes  retching  and  vomiting  are  symptoms. 
By  pressure  upon  the  crop  the  contents  will  be  expelled  via 
mouth,  emitting  a  very  offensive  odor.  The  birds  may  die 
from  exhaustion. 

Diagnosis.— This  is  determined  quite  accurately  by  a  care- 
ful examination  of  the  crop  and  the  character  and  condition 
of  the  contents. 

Prognosis.— When  not  a  symptom  or  complication  of 
some  other  disease  (cholera,  thrush,  etc.),  the  prognosis  is 
usually  considered  favorable  and  the  majority  respond  readily 
to  treatment.  When  a  large  number  of  a  flock  is  affected, 
indicating  a  severe  catarrhal  inflammation,  the  prognosis  is 
less  favorable  owing  to  the  difficulty  in  applying  prompt 
remedial  measures.  Repeated  return  of  the  condition  often 
produces  the  so-called  hanging  crop  or  dilation. 

Treatment.—  Hygienic.— The  birds  should  be  provided  with 
a  clean,  dry  place  free  from  extremes  in  temperature. 

Dietetic.— In  mild  cases  where  the  appetite  is  not  entirely 
lost,  solid  food  should  be  withheld  for  a  day  or  so,  only  a 
small  quantity  of  liquids  being  allowed. 


OBSTRUCTION  OF  CROP  IN  BIRDS— HARD  CROP     139 

Medical.— Before  administering  medicinal  agents  it  is 
necessary  to  thoroughly  empty  the  crop  which -is  done  in  the 
following  manner:  The  bird  is  held  with  its  head  pendant, 
and  the  crop  carefully  manipulated  and  compressed  between 
the  thumb  and  fingers,  when  the  contents  will  flow  out  via 
mouth.  The  crop  should  be  thoroughly  compressed  from 
behind  toward  the  mouth  until  it  is  completely  emptied. 
Ten  to  30  c.c.  of  a  bicarbonate  of  soda  solution  (2  per  cent.) 
is  then  administered  to  neutralize  the  acidity  of  the  retained 
contents  and  to  dissolve  the  accumulated  mucus  from  the 
membrane.  For  a  few  days  small  doses  of  sodium  bicar- 
bonate (0.15)  or  bismuth  subnitrate  (0.10)  may  be  admin- 
istered daily.  Only  small  quantities  of  food  should  be 
allowed  for  at  least  four  to  five  days. 

OBSTRUCTION  OF  THE  CROP  IN  BIRDS.     HARD  CROP. 

Definition.— An  impaction  of  the  crop. 

Etiology.— The  obstruction  of  the  crop  is  often  seen  from 
overfeeding,  especially  with  dry  foods  (oats,  rye,  corn,  peas, 
etc.)  or  with  quantities  of  straw,  leaves,  grasses,  and  other 
indigestible  substances  swallowed  by  the  bird.  In  water 
birds  it  occurs  from  eating  large  quantities  of  certain  grasses 
(triticum  repens,  etc.).  Turkeys  are  most  commonly  affected 
by  eating  large  quantities  of  insects  (grasshoppers,  etc.), 
straw,  grains  and  grasses.  Further,  swallowing  various  kinds 
of  foreign  bodies  with  the  food  (metallic  substances,  large 
stones,  pieces  of  glass,  bones,  egg  shells,  or  large  numbers  of 
very  small  stones,  etc.)  often  produces  impaction  of  the  crop. 

In  some  mild  cases  of  catarrh  with  irritation  of  the  mucous 
membrane  the  birds  often  eat  large  quantities  of  indigestible 
substances  leading  to  an  impaction.  Animal  parasites  when 
in  large  numbers  will  produce  the  same  result. 

Symptoms.— The  birds  are  dull,  stupid,  show  rough  plu- 
mage, pale  comb  and  wattles,  with  a  constant  opening  and 
closing  of  the  beak;  or  the  beak  is  held  open  to  facilitate 
breathing  which  is  often  interfered  with  by  pressure  of  the 
enlarged  crop  upon  the  trachea.  A  disagreeable  odor  ema- 
nates from  the  mouth,  and  often  quantities  of  fermented  or 


140  DISEASES  OF   THE  ESOPHAGUS 

decomposed  liquids  and  food  particles  escape  from  the 
mouth  and  nostrils.  The  appetite  in  the  early  stages  is 
lessened  and  later  entirely  lost.  The  crop  when  examined 
will  be  found  greatly  distended,  hard  and  more  or  less  firm 
on  palpation.  In  some  cases  it  is  very  hard,  producing  the 
so-called  "  hard  crop."  When  metallic  substances  are  present, 
it  is  possible  in  some  cases  to  palpate  them,  or  in  case  of 
sharp  objects  they  are  sometimes  found  projecting  through 
the  muscular  walls  and  skin.  With  the  aid  of  the  Roentgen 
rays  the  character  and  size  of  the  foreign  body  can  often  be 
revealed. 

Prognosis.— This  depends  upon  the  character  of  the 
impacted  material,  its  duration  and  the  condition  of  the  bird. 
In  most  cases  if  allowed  to  continue  it  will  result  fatally.  In 
some  cases,  the  crop  becomes  enormously  distended,  pro- 
ducing the  so-called  "hanging  crop." 

Treatment.— The  early  indication  in  the  treatment  is  to 
massage  the  crop  and  try  to  remove  the  contents  via  mouth. 
This  is  best  done  by  suspending  the  bird  head  downward, 
and  massaging  and  kneading  the  crop  carefully  which  crushes 
the  crop  contents  so  that  they  may  be  gently  forced  into  the 
mouth.  Often  the  entire  contents  can  be  removed  in  this 
manner.  The  administration  of  a  small  quantity  of  linseed 
oil  to  lubricate  the  esophagus  will  often  assist  when  applying 
the  above  method. 

\Vhere  this  method  will  not  suffice,  it  will  be  necessary 
to  open  the  crop  and  remove  the  contents  through  the 
incision.  The  feathers  should  be  pulled  out  over  a  space 
about  \\  inches  wide  and  2-3  inches  long  at  the  point  of 
greatest  protrusion.  The  field  of  operation  should  be 
thoroughly  disinfected.  The  incision  can  be  enlarged  suffi- 
ciently to  admit  of  the  crop  contents  being  easily  removed. 
A  blunt  curette  or  pincette  is  useful  in  assisting  removal. 
The  crop  should  be  thoroughly  irrigated  with  a  sodium 
bicarbonate  solution  (2  per  cent.),  and  the  edges  of  the 
wound  disinfected  with  a  boric  acid  solution  (2  per  cent.). 
The  wound  is  then  stitched  with  a  single  row  of  interrupted 
sutures  sufficiently  close  together  to  prevent  the  escape  of 
anv  contents.  The  stitches  should  not  be  removed  for  at 


NEOPLASMS  OF   THE  ESOPHAGUS  141 

least  eight  to  ten  days.  All  food  and  liquids  should  be  with- 
held for  twenty-four  hours  and  for  the  next  four  or  five  days 
only  a  small  quantity  of  liquid  food  given. 

NEOPLASMS  OF  THE  ESOPHAGUS. 

Tumors  of  the  esophagus  are  very  rare  and  those  occurring 
most  commonly  are:  Epithelioma,  sarcoma  and  carcinoma. 
These  occur  most  frequently  via  metastasis.  Retention 
cysts  are  found  at  the  anterior  part  of  the  esophagus. 

Symptoms.— Tumors  produce  a  narrowing  of  the  esophagus 
similar  to  stenosis  (see  Stenosis).  When  this  occurs  in  the 
cervical  portion  the  condition  may  be  determined  by  palpa- 
tion. A  differentiation  from  foreign  bodies,  diverticula  and 
dilatation  is  often  made  possible  by  careful  palpation. 

Diagnosis.— The  kind  of  tumor  can  only  be  determined 
by  obtaining  some  of  the  enlargement  for  microscopical 
examination. 

Prognosis.— When  malignant  tumors  (carcinoma,  sarcoma, 
epithelioma)  are  present,  the  prognosis  is  very  unfavorable; 
retention  cysts  unless  they  interfere  with  nutrition  are  more 
favorable.  Small  ones  may  be  present  without  being  noticed 
for  a  long  time. 

Treatment. — No  treatment  should  be  attempted  for 
malignant  tumors.  Retention  cysts  may  be  reduced  by 
pressure  from  the  outside  or  esophagotomy  (see  Esophagot- 
omy)  may  be  performed  and  the  cyst  wall  destroyed. 


CHAPTER  VIII. 
DISEASES  OF  THE  STOMACH. 

Examination.— The  stomach  can  be  examined  as  follows: 
1.  By  the  character,  condition  and  quantity  of  the  contents, 
which  may  be  obtained :  (a)  By  the  use  of  an  emetic  (apo- 
morphin  0.0016.-0.003  etc.),  (6)  by  natural  vomiting,  (c)  by 
the  use  of  a  stomach  tube  or  (d)  through  gastrotomy  (see 
Foreign  Bodies  in  the  Stomach). 

2.  Palpation  over  the  region  of  the  stomach  will  cause 
pain  in  acute  inflammatory  conditions,  although  this  may 
be  confused  with  painful  conditions  of  the  liver,  peritonitis 
and  enteritis. 

3.  By  performing  laparotomy  and  making  a  direct  exami- 
nation of  the  stomach.    The  mucous  membrane  may  also 
be  examined  directly  by  performing  gastrotomy. 

GASTRITIS. 

Gastritis  is  an  inflammation  of  the  stomach.  The  following 
forms  are  recognized:  (a)  Acute,  and  (6)  chronic. 

Acute  Gastritis.  —  Simple  Catarrh  of  the  Stomach.  Acute 
Dyspepsia.—  Definition.— An  acute  catarrhal  inflammation 
of  the  mucous  membrane  of  the  stomach  which  may  involve 
the  entire  wall. 

Etiology.— Acute  catarrhal  gastritis  is  usually  due  to  errors 
in  diet.  The  ingestion  of  more  food  than  can  be  digested, 
irregular  feeding,  or  eating  unsuitable  food,  which  is  partially 
decomposed  containing  ptomaines  (cadavers,  garbage,  etc.), 
and  hard  pieces  of  bone,  cartilage  and  tendon  are  very  com- 
mon causes  of  this  condition.  Injuries  to  the  epigastrium 
(kicks,  blows,  and  being  run  over  by  vehicles,  etc.). 

Chemical. — Various  chemical  substances  (phenol,  arsenic, 
mercury,  phosphorus,  etc.)  when  taken  accidentally  or 


GASTRITIS  143 

given  intentionally  will  produce  a  very  serious  form  of  gas- 
tritis (toxic).  An  excess  of  sodium  chlorid  given  in  the  food 
to  birds  will  often  produce  a  severe  gastritis. 

Thermic.— Very  hot,  solid  foods  and  liquids,  or  very  cold, 
frozen  foods  will  sometimes  produce  a  gastritis.  Rabbits 
eating  frozen  vegetables  are  thus  often  affected. 

Infectious.— Infectious  gastritis  occurs  during  the  course 
of  most  infectious  diseases  (distemper,  rabies,  etc.) . 

Parasites.— See  Parasites  of  the  Stomach. 

Pathology.— Acute  catarrhal  gastritis  is  characterized  by  a 
swelling  and  hyperemia  of  the  mucous  membrane  which  is 
often  corrugated,  and  intensely  red  with  small  ecchymoses 
appearing  over  the  surface.  Small  superficial  erosions  are 
occasionally  noticed. 

Symptoms.— Vomiting  occurs  early  and  is  the  most  promi- 
nent symptom  often  being  quite  frequent  and  in  severe  cases 
very  persistent.  The  vomitus  in  the  beginning  consists  of 
quantities  of  undigested  and  decomposed  food  material 
covered  with  mucus  and  sometimes  streaked  with  blood,  with 
a  very  disagreeable  odor.  When  due  to  chemical  causes  it 
often  has  the  characteristic  odor  of  the  poison.  Later  the 
vomitus  consists  almost  entirely  of  small  amounts  of  frothy 
mucus,  and  when  the  vomiting  is  severe  there  is  often  an 
admixture  of  bile.  The  appetite  in  severe  cases  is  completely 
lost  and  in  mild  cases  it  is  variable  and  vitiated,  the  animal 
eating  unnatural  material.  Bowel  complications  (see 
Enteritis)  invariably  follow  severe  cases  of  gastritis. 

On  examination  the  animals  show  pain  on  palpation  over 
the  region  of  the  stomach,  which  manipulation  often  induces 
vomiting.  There  is  a  grayish-white  deposit  over  the  dorsal 
surface  of  the  tongue  (furred  tongue);  the  temperature  is 
elevated  in  the  early  stages  of  severe  cases  (103°-105°  F.), 
later  the  temperature  is  subnormal  (97°-100°  F.).  In  milder 
cases  the  temperature  shows  but  little  variation. 

The  general  symptoms  in  the  early  stages  of  severe  gas- 
tritis are  those  of  uneasiness  and  intense  pain  (howling, 
etc.),  stiffness  and  considerable  pain  which  is  shown  when  the 
patient  is  moved  about.  In  milder  cases  the  only  symptoms 
noticeable  are  occasional  vomiting  and  variable  appetite. 


144  DISEASES  OF  THE  STOMACH 

Diagnosis.— Acute  non-infectious  gastritis  is  not  very 
difficult  to  diagnose  as  the  symptoms  are  very  characteristic 
and  quite  often  the  anamnesis  is  of  value.  The  primary 
infectious  form,  however,  may  be  confused  with  that  due  to 
specific  infectious  diseases  (distemper,  etc.),  but  this  can  be 
distinguished  by  the  general  symptoms,  especially  the  tem- 
perature which  in  the  latter  cases  rises  more  abruptly  and 
shows  less  variation  than  in  the  former. 

Prognosis. — In  primary  acute  gastritis,  due  to  errors  in 
feeding,  the  prognosis  is  usually  favorable. 

When  due  to  poisons,  foreign  bodies,  and  injuries,  it 
depends  largely  upon  the  extent  of  injury  to  the  stomach 
and  the  possibility  of  removing  the  cause.  In  infectious 
gastritis,  when  not  due  to  specific  infection,  the  prognosis  is 
usually  favorable,  but  if  accompanying  a  specific  disease  it 
depends  on  the  primary  disease. 

Treatment. — Dietetic.  —  In  strong  animals  all  food  should 
be  withheld  twenty-four  to  forty-eight  hours  and  then  only 
a  small  amount  of  easily  digested  food  given  at  frequent 
intervals  until  recovery  takes  place.  In  weak  individuals 
easily  or  predigested  food  may  be  allowed  unless  it  induces 
persistent  vomiting  when  nourishment  should  be  given  via 
the  rectum. 

Medical.— Mild  cases  usually  recover  promptly  following 
the  use  of  a  purgative  (ol.  ricini,  dogs  15.0  to  60.0,  cats  5.0 
to  20.0;  calomel,  dogs  0.3-0.4,  cats  0.01-0.005;  cascara  fld. 
ext.  dogs,  5.0-10.0,  cats  1.0-5.0). 

In  severe  cases  unless  vomiting  has  occurred  an  emetic, 
such  as  apomorphin  hydrochlorate  (dogs  0.005-0.01,  cats 
0.002-0.005)  given  subcutaneously  is  indicated  to  expel 
irritating  material  and  foreign  bodies  which  may  be  present. 
Following  vomiting,  irrigation  of  the  stomach  with  a  sodium 
bicarbonate  solution  (2  per  cent.)  is  advisable  to  remove  irri- 
tating material  from  the  surface  of  the  mucous  membrane. 
This  can  be  accomplished  by  the  use  of  a  rubber  tube  or 
horse  catheter  inserted  into  the  stomach.  The  warm  sodium 
bicarbonate  solution  (500.0-1000.0)  may  be  introduced  into 
the  stomach  by  elevating  the  free  end  of  the  tube  and  using 
a  funnel.  Allow  the  tube  to  remain  in  the  stomach  for  a  few 


GASTRITIS  145 

minutes,  then  depress  it  to  allow  the  fluid  to  flow  out  again. 
Repeat  this  two  or  three  times.  To  stimulate  the  functions 
of  the  stomach,  stomachic  tonics  are  indicated : 

For  Dog. 

H — Ferri  et  quinnse  citratis 4.0 

Pepsini 1.0 

Sacchari  albae 2.0 

Misce  et  fiat  pulv.  No.  XX. 

Sig. — Give  a  powder  every  twelve  hours. 

For  Cats. 
One-half  the  above  dose. 

or 

For  Dog. 

J$ — Tincturse  nucis  vomicse •  .  .  .  7.0 

Tincturse  gentianse 10.0 

Aqua  communis 60.0 

Misce  et  fiat  solutio. 

Sig. — Give  teaspoonful  twice  daily. 

For  Cats. 

T$ — Tinctura?  nucis  vomica3 1.0 

Syrupi  auranti 60.0 

Misce  et  fiat  solutio. 

Sig. — Give  teaspoonful  once  daily. 

or 

I^ — Acidi  hydrochlorici 2.5 

Tinctura  gentianse  comp 10.0 

Aqua 150.0 

Misce  et  fiat  solutio. 

Sig. — Give  teaspoonful  three  times  a  day. 

Vomiting  is  often  present  in  these  cases  but  it  is  usually 
stopped  by  the  removal  of  the  irritating  material  through 
irrigation  of  the  stomach  (lavage),  but  if  it  persists  it  may 
be  controlled  by  using  sedatives. 

For  Dog. 

}\ — Bismuth!  subnitratis 

Opii  pulvorati 

Sacchari  alb* '    <> 

Misce  et  fiat  pulv.  No.  VI. 

Sig. — Give  one  powder  every  four  to  six  hours  until  vomiting  is  reduced. 
10 


146  DISEASES  OF   THE  STOMACH 

When  due  to  chemicals  the  proper  antidote  should  be 
administered  (see  Poisons). 

Surgical. — When  foreign  bodies  are  present  and  cannot  be 
expelled  by  emesis  or  purgation,  gastrotomy  must  be  per- 
formed (see  Foreign  Bodies  of  the  Stomach) . 

Chronic  Gastritis.  —  Chronic  Catarrh  of  the  Stomach. 
Chronic  Dyspepsia. — Definition. — A  chronic  catarrh  of  the 
stomach  with  a  disturbance  in  digestion,  increased  mucus 
formation,  changes  in  the  gastric  secretions,  partial  paralysis 
of  the  muscular  walls  and  alterations  in  the  structure  of  the 
mucosa. 

Etiology. — Chronic  gastritis  is  a  rather  common  condition 
especially  in  the  dog.  It  results  very  frequently  from  several 
repeated  attacks  of  acute  gastritis  and  is  therefore  produced 
by  causes  similar  to  those  found  under  acute  gastritis  (see 
Etiology  of  Acute  Gastritis).  It  often  occurs  as  a  secondary 
complication  to  various  diseases,  such  as  ulceration  of  the 
stomach,  gastric  tumors,  diseases  of  the  liver,  chronic  con- 
stitutional diseases  (anemia,  chlorosis,  chronic  nephritis, 
etc.).  Parasites,  by  constant  irritation  to  the  membranes 
for  a  long  period,  will  produce  chronic  gastritis  (see  Parasites). 

Pathology. —The  stomach  is  usually  enlarged,  the  mucous 
membrane  pale,  becomes  gray  in  color  and  its  surface  covered 
with  a  thick,  tenacious  mucus.  The  veins  are  found  distended 
and  small  hemorrhagic  erosions  and  ecchymoses  are  seen 
distributed  over  the  mucous  membrane.  In  the  later  stages 
the  mucous  membrane  becomes  greatly  thickened,  especially 
toward  the  pyloris,  and  the  mucous  glands  large  and  indur- 
ated from  the  constant  irritation.  Microscopically  there  is 
every  evidence  of  a  parenchymatous  and  an  interstitial 
inflammation. 

Symptoms.— This  affection  persists  for  an  indefinite  period 
and  like  most  chronic  conditions  changes  from  time  to  time. 
In  the  dog,  the  animal  most  commonly  affected,  the  appetite 
is  variable,  sometimes  greatly  impaired  and  at  other  times 
very  good.  Vomiting  and  retching  are  frequent  symptoms 
and  are  especially  noticeable  a  short  time  after  eating.  The 
vomited  material  consists  of  undigested  food  particles  covered 
with  a  thick,  tenacious  mucus  and  has  a  very  sour,  disagree- 


GASTRITIS  147 

able  odor.  After  severe  and  prolonged  paroxysms  of  vomit- 
ing, the  mucus  is  frequently  mixed  .with  blood  from  the  rup- 
turing of  small  bloodvessels  at  the  seat  of  the  erosions.  The 
chemical  analysis  of  the  vomited  material  shows  the  presence 
of  abnormal  acids,  such  as  butyric  or  sometimes  acetic  in 
addition  to  lactic  acid,  while  the  hydrochloric  acid  is  either 
absent  or  greatly  reduced  in  quantity.  Digestion,  therefore, 
is  delayed  and  decomposition  and  gas  formation  favored 
which  in  some  cases  greatly  distends  the  stomach.  Con- 
stipation is  usually  present,  but  in  some  cases  there  is  diar- 
rhea and  the  undigested  food  passes  rapidly  through  the 
bowels.  The  urine  is  often  reduced  in  quantity,  has  a  high 
color  and  a  very  disagreeable  odor.  There  are  general 
symptoms  of  disturbed  nutrition,  resulting  in  emaciation  and 
general  weakness. 

Diagnosis.— A  diagnosis  of  chronic  gastritis  is  not  always 
easy  as  the  symptoms  present  are  also  indicative  of  other 
conditions.  However,  by  a  careful  analysis  of  the  symptoms 
and  considering  the  condition  of  the  animal  and  a  careful 
examination  of  the  contents  of  the  stomach,  the  diagnosis 
may  be  made  with  a  certain  degree  of  accuracy. 

Prognosis.— A  complete  recovery  in  this  condition  is  prac- 
tically impossible.  However,  a  great  number  of  cases  will 
improve  with  careful  diet  and  treatment.  As  a  rule  an 
unfavorable  prognosis  should  be  made  owing  to  the  patho- 
logical changes  which  have  taken  place  in  the  mucosa  and 
muscular  walls  of  the  stomach. 

Treatment.— Dietetic.— The  dietetic  treatment  is  of  greater 
importance  in  the  majority  of  cases  than  the  use  of  medicines. 
A  careful  regulation  of  the  diet  is  always  to  be  insisted  upon. 
Only  small  quantities  of  easily  digested  food  should  be  given 
for  the  first  few  days  (beef  extract,  rice  soup,  white  of  eggs, 
small  quantities  of  milk,  oatmeal  gruel).  In  cats  very  small 
amounts  of  milk  or  rice  soup  show  the  best  results. 

Medical. — A  thorough  lavage  of  the  stomach  witli  warm 
water  or  a  sodium  bicarbonate  solution  (2  per  cent.)  should 
always  be  the  first  tiling  attempted.  It  can  be  done  readily 
in  the  following  manner:  The  animal  is  placed  on  a  table 
and  held  by  an  assistant;  a  stomach  tube  is  then  iiitro- 


148  DISEASES  OF   THE  STOMACH 

duced  into  the  stomach  (see  Foreign  Bodies  in  Esophagus) 
and  the  free  end  depressed  to  allow  some  of  the  stomach 
contents  to  flow  out.  Should  the  contents  be  too  thick  to 
pass  out  through  the  tube,  some  of  the  2  per  cent,  soda 
solution  (about  500  c.c.)  is  introduced  into  the  stomach  by 
elevating  the  free  end  of  the  tube.  Attach  a  funnel  to  the 
tube  and  gradually  pour  in  the  solution.  After  it  has  entered 
the  stomach  by  gravity,  allow  it  to  remain  for  a  few  minutes, 
depress  the  tube  and  allow  it  to  flow  out  again.  This  opera- 
tion should  be  repeated  until  the  liquid  flows  out  freely  and 
is  clear  of  food  particles  and  mucus.  It  is  advisable  in  severe 
cases  to  repeat  this  treatment  daily  for  three  or  four  days  and 
after  this  at  biweekly  intervals. 

Bitter  stomachics  (tincture  gentian  compound  4.0;  or 
tincture  of  Colombo  2.0)  are  indicated  before  feeding  to 
stimulate  the  mucous  membrane  and  the  muscular  walls  of 
the  stomach.  Small  doses  of  pepsin  and  hydrochloric  acid 
are  indicated  in  severe  cases  to  assist  in  digesting  the  food. 
These  should  be  administered  shortly  after  feeding  to  obtain 
the  best  results.  Artificial  Carlsbad  salts  (8.0)  given  twice 
daily  is  valuable  as  a  stomachic  and  anticatarrhal  agent  for 
the  mucous  membrane.  Further,  in  cases  where  there  is 
considerable  fermentation,  salicylic  acid  (0.2-0.5)  or  creosote 
(0.1)  is  useful  to  arrest  the  fermentation.  These  drugs  should 
be  repeated  at  each  meal  to  obtain  the  desired  results. 


FOREIGN  BODIES  IN  THE  STOMACH. 

Etiology.— Dogs  often  swallow  foreign  bodies  with  the 
food,  or  during  play,  which  pass  into  the  stomach  and  pro- 
duce symptoms  of  a  serious  nature.  Most  commonly  the 
foreign  bodies  consist  of  small  rubber  balls,  glass  marbles, 
peach  stones,  stones,  needles,  pins,  and  meat  skewers.  Dur- 
ing rabies  (see  Rabies),  owing  to  the  vitiated  appetite,  dogs 
eat  large  quantities  of  foreign  material,  such  as  splinters  of 
wood,  pieces  of  cloth,  stones,  straw,  etc. 

Cats  often  take  with  the  food,  needles,  pins,  fish  bones, 
fruit  stones,  which  enter  the  stomach  and  remain  for  some 


FOREIGN  BODIES  IN   THE  STOMACH  149 

time  producing  alarming  symptoms.  Birds  often  pick  up 
metallic  substances  with  the  food  (nails,  pins,  etc.). 

These  substances  after  entering  the  stomach  may  remain 
for  a  long  time  without  producing  any  marked  disturbance. 
However,  as  a  rule  they  produce  an  acute  or  chronic  gastritis 
and  sharp  objects  may  penetrate  the  walls  of  the  stomach 
producing  an  acute  inflammatory  condition,  or  peritonitis. 
Hair  balls  are  occasionally  found  in  the  stomach  of  rabbits 
and  dogs. 

Symptoms. — In  a  large  percentage  of  cases  where  foreign 
bodies  are  taken  there  are  no  symptoms  noticeable,  espec- 
ially where  the  foreign  bodies  are  small  and  regular  in  outline. 
These  will  often  pass  out  via  the  intestinal  tract  or  be  vomited 
up  without  interfering  with  the  function  of  the  stomach  or 
producing  general  symptoms.  When  the  foreign  bodies  are 
of  large  size,  irregular  in  outline,  or  sharp,  they  often  produce 
symptoms  of  acute  or  chronic  gastritis  (see  Acute  and 
Chronic  Gastritis).  Very  commonly  the  foreign  bodies 
produce  extensive  irritation  of  the  mucous  membrane, 
penetrate  the  walls  of  the  stomach  or  obstruct  the  pylorus 
producing  severe  vomiting  (which  is  persistent),  complete 
loss  of  appetite,  intense  thirst,  hematemesis  (from  the  ero- 
sions on  the  mucous  membranes  or  some  of  the  bloodvessels 
being  injured  by  the  sharp  objects).  Where  extensive  injury 
is  produced  in  the  membranes,  the  animals  often  show  excit- 
able symptoms,  howling  and  other  symptoms  similar  to 
rabies  (see  Rabies),  stiffness  in  gait,  and  wralk  with  the  back 
arched.  By  palpation  over  the  region  of  the  stomach  (espe- 
cially in  cats,  rabbits  and  in  some  breeds  of  dogs),  the  foreign 
bodies  can  often  be  detected  and  their  character  determined. 
WThen  perforation  of  the  walls  of  the  stomach  is  produced  by 
sharp  objects,  symptoms  of  acute  peritonitis  develop  (see 
Peritonitis).  Lastly,  under  symptoms  of  general  weakness, 
subnormal  temperature,  and  very  weak,  imperceptible  pulse 
the  animals  often  die  from  exhaustion. 

Diagnosis.— The  characteristic  symptoms,  the  anamnesis 
and  careful  palpation  make  the  diagnosis  rather  easy  when 
foreign  bodies  are  present  in  the  stomach.  Direct  palpa- 
tion of  the  walls  of  the  stomach  (explorative  laparotomy) 


150  DISEASES  OF   THE  STOMACH 

is  to  be  recommended  in  some  cases  where  the  diagnosis 
is  in  doubt.  In  other  cases  the  Roentgen  rays  will  assist 
in  locating  the  foreign  body.  However,  this  method  is 
rather  difficult  owing  to  the  location  of  the  stomach  and  its 
relationship  to  the  adjacent  organs. 

Prognosis.— The  prognosis  depends  upon  the  character, 
size  and  condition  of  the  foreign  body,  the  general  condition 
of  the  animal  and  the  possibility  of  its  removal.  In  most 
cases  the  prognosis  should  be  made  unfavorable. 

Treatment.— Medical.— Emetics  are  often  of  value  in 
removing  foreign  bodies  from  the  stomach.  Subcutaneous 
injection  of  apomorphin  hydrochlorate  (0.005-0.01)  should 
be  administered  and  the  vomitus  carefully  inspected  to 
determine  whether  or  not  the  foreign  body  has  been  ejected. 
Should  this  method  fail,  surgical  means  should  be  employed 
as  early  as  possible. 

Surgical.— This  consists  in  performing  laparotomy  and 
gastrotomy-as  follows: 

Laparotomy.— This  operation  should  be  performed  at  the 
median  line  whenever  it  is  possible  to  do  so.  When  the  inci- 
sion is  made  through  the  linea  alba,  healing  may  not  be  quite 
so  rapid  as  if  it  were  made  just  to  one  side  through  the 
muscular  tissue.  The  former  position  is  to  be  preferred, 
however,  as  there  is  little  or  no  hemorrhage  to  interfere  with 
the  operation,  and,  as  both  sides  of  the  wound  are  alike,  the 
edges  can  be  more  evenly  approximated  by  suturing. 

The  animal  being  secured  in  the  dorsal  position,  and 
under  general  anesthesia,  the  skin  at  the  field  of  opera- 
tion is  clipped  and  shaved  of  all  hair  and  cleansed,  first  with 
soap  and  warm  water  and  then  with  antiseptic  solution 
(boric  acid  2  per  cent.;  creolin  2  per  cent.;  mercuric  bichlorid 
1-2000). 

When  the  operation  is  not  extremely  urgent,  it  is  best  to 
apply  an  antiseptic  pack  (boric  acid  powder)  over  the  field 
of  operation  after  cleansing  for  the  twenty-four  hours  preced- 
ing in  order  to  ensure  better  antisepsis  of  the  skin.  Sterilize 
the  following  instruments:  Scalpel,  probe  pointed  bistoury, 
scissors,  artery  forceps,  a  full  curved  needle  and  suturing 
material.  The  incision  is  made  with  a  sharp  scalpel  through 


FOREIGN  BODIES  IN  THE  STOMACH  151 

all  the  tissues  down  to  the  peritoneum.  Considerable  care 
should  be  taken  in  going  through  this  in  order  to  avoid 
puncturing  the  abdominal  organs.  It  is  best  to  grasp  a 
small  part  with  forceps  and  clip  it  out  with  the  scissors, 
making  an  opening  large  enough  to  insert  the  probe  pointed 
bistoury  and  with  this  enlarge  the  incision  the  desired  length 
which  depends  on  the  operation  to  be  performed  and  on  the 
size  of  the  operator's  finger.  One  and  one-half  inches  is 
sufficient  for  most  cases,  although  it  may  be  made  large 
enough  in  a  large  dog  to  admit  the  entire  hand.  Absorbent 
cotton  or  a  pledget  of  gauze  moistened  with  antiseptic  solu- 
tion is  useful  to  keep  the  wound  free  from  blood,  but  none  of 
the  antiseptic  fluids  should  be  allowed  to  enter  the  peri- 
toneal cavity.  Sterile  water  should  be  used  to  cleanse  any 
portion  of  the  viscera  or  peritoneum  exposed .  To  suture  the 
laparotomy  wound,  use  medium-sized  silk  or  linen  suture 
material  and  make  interrupted  sutures  about  one-quarter  to 
three-eighths  of  an  inch  apart  depending  upon  the  thickness 
of  the  abdominal  wall.  Using  a  long,  slender,  full  curved 
needle,  start  about  one-quarter  of  an  inch  from  the  margin 
of  the  wound,  and  pass  it  through  the  muscle  and  peritoneum, 
having  the  index  finger  inserted  in  the  wound  to  prevent 
the  needle  entering  the  viscera,  particularly  the  intestine  or 
bladder,  and  bring  it  out  on  the  other  side  at  the  same  dis- 
tance from  the  margin  so  that  when  tied,  and  swelling  occurs, 
one  edge  will  not  be  forced  above  the  other.  The  surgeon's 
knot,  i.  e.,  wrapping  the  first  half  of  the  knot  twice,  should 
be  used,  and  if  omentum  is  forced  out  when  suturing  it  may 
be  pushed  back  with  blunt  forceps  as  the  knot  is  being  tied. 
To  avoid  a  hernia  following  this  operation,  be  sure  ^that  the 
sutures  pass  through  all  the  layers  of  the  abdominal  wall, 
i.  e.,  skin,  muscle,  aponeurosis,  and  peritoneum. 

Gastrotomy.— Perform  laparotomy,  as  above,  in  the  median 
line  and  about  one-quarter  of  an  inch  posterior  to  the  xiphoid 
cartilage,  making  the  incision  about  two  and  a  half  inches 
long.  Grasp  the  stomach  with  the  thumb  and  finger  and 
draw  it  out  as  far  as  possible.  Tack  it  securely  with  sterile 
cotton  squeezed  out  with  sterile  water,  or  with  dry  sterile 
gauze  to  prevent  any  of  the  stomach  contents  from  entering 


152  DISEASES  OF   THE  STOMACH 

the  peritoneal  cavity  when  the  incision  is  made.  Have  an 
assistant  support  the  stomach  by  grasping  it  at  either  end 
with  thumb  and  finger.  Make  the  incision  at  the  greater 
curvature  and  at  right  angles  to  the  long  axis  of  the  stomach, 
and  at  a  point  where  the  bloodvessels  are  few  and  small. 
The  organ  is  best  opened  by  puncturing  with  a  sharp  pointed 
bistoury  through  the  muscular  and  mucous  coats  and  then 
enlarging  it  with  the  scissors,  the  length  of  incision  depending 
upon  the  size  of  the  foreign  body  to  be  removed.  The  removal 
of  large  sharp  pointed  bodies  must  be  done  with  care  and,  if 
possible,  they  should  be  crushed  to  avoid  making  too  long 
an  incision.  Blunt  dressing  forceps  are  useful  to  grasp  small 
objects.  The  division  of  the  muscular  coat  allows  it  to  con- 
tract while  the  mucous  coat  projects  out  through  the  excess 
of  mucous  membrane  so  that  its  edges  may  be  evenly  approxi- 
mated. Suture  the  mucous  membrane  with  interrupted 
sutures  one-eighth  of  an  inch  apart,  then  suture  the  muscular 
coat  in  the  same  way,  being  careful  to  bring  the  edges  in 
close  contact.  A  Lembert  suture  is  then  applied  over  the 
wound  to  invert  it.  This  is  made  by  inserting  the  needle 
through  a  small  portion  of  the  muscular  coat  on  one  side  of 
the  wound,  carrying  it  over  and  inserting  the  same  way  on 
the  other  side,  and  these  when  tied  will  invert  the  wound 
and  bring  the  peritoneal  surfaces  of  either  side  of  the  wound 
in  apposition,  which  favors  an  early  adhesion  and  prevents 
the  escape  of  the  stomach  contents.  These  sutures  will  be 
encapsuled  and  are  not  to  be  removed.  Cleanse  the  surface 
of  the  stomach  and  return  to  the  abdominal  cavity.  All 
food  should  be  withheld  for  twenty-four  hours,  after  which 
time  a  small  amount  of  liquid  food  (milk,  beef  broth)  may 
be  fed  for  a  few  days  when  the  regular  diet  may  be  given. 

ACUTE  DILATATION  OF  THE  STOMACH. 

Etiology.— This  condition  is  observed  more  frequently  in 
dogs  and  rabbits  than  in  other  small  animals.  It  is  most 
frequently  produced  by  overloading  the  stomach,  especially 
when  large  quantities  of  indigestible  or  dry  foods  are  taken. 
Such  substances  as  potatoes,  bread  (dry),  dog  biscuits,  blood, 


ACUTE  DILATATION  OF   THE  STOMACH          153 

some  green  foods,  grains,  etc.,  afe  the  ones  most  liable  to 
produce  the  condition.  Dogs  when  very  hungry,  will  often 
eat  an  entire  bird,  rat  or  mouse,  without  masticating  it. 
When  the  mass  reaches  the  stomach  it  will  cause  a  sudden 
dilatation. 

Debilitating  Condition.— Both  general  and  local,  such  as 
rachitis,  anemia,  toxic  conditions,  infections,  diseases  of  the 
heart,  etc.  These  conditions  may  be  the  result  of  various 
influences  which  alter  the  tone  of  the  muscular  wall,  either 
indirectly  by  affecting  nervous  control,  or  more  directly  by 
toxic  action  on  the  muscle. 

Previous  gastric  diseases  often  predispose  to  the  condition, 
usually  through  fermentation,  distending  the  walls  leading  to 
the  gaseous  form  of  acute  dilatation.  Excessive  secretions 
at  the  same  time  will  assist  in  the  dilatation. 

Injuries.— Such  as  blows  on  the  abdomen,  being  run  over 
by  vehicles,  spinal  injuries,  abdominal  operations  (ovari- 
otomy) have  been  known  to  produce  dilatation. 

Pathology.— The  stomach  is  usually  of  enormous  size, 
extending  back  nearly  to  the  pelvis.  The  color  is  bluish, 
purple-red,  or  pale,  and  the  wall  is  often  very  thin.  The 
dilatation  not  infrequently  involves  the  duodenum  and  in 
some  cases  may  extend  to  the  other  small  intestines.  At 
times  the  stomach  will  be  found  distended  with  hard,  undi- 
gested food  masses,  and  in  rabbits  rupture  of  the  stomach  at 
the  greater  curvature  often  takes  place  from  the  distention 
with  food  and  gases. 

Symptoms. — Vomiting  is  one  of  the  early  symptoms  and 
the  vomitus  consists  in  many  cases  of  particles  of  hard  food 
masses,  fluids,  etc.  Owing  to  the  act  of  vomiting  taking  place 
early,  some  of  the  material  will  be  ejected,  so  that  in  many 
cases  this  will  be  the  principal  symptom  noticeable.  However, 
in  some  cases  where  the  stomach  contents  are  not  removed  by 
vomiting,  more  serious  symptoms  develop.  There  is  profuse 
ptyalism,  accelerated  pulse,  dyspnea,  evidences  of  severe  pain 
such  as  howling,  excitement,  etc.  In  severe  cases  fermentation 
often  takes  place  in  the  intestinal  tract,  producing  severe  dysp- 
nea and  death  in  a  short  time.  In  rabbits  and  some  breeds 
of  dogs,  by  palpation,  the  stomach  will  often  be  found  greatly 


154  DISEASES  OF  THE  STOMACH 

distended  with  food  masses,  gas,  and  fluids,  which  can  readily 
be  distinguished  through  the  abdominal  walls.  Very  often 
the  symptoms  of  this  condition  are  similar  to  acute  gastritis 
(see  Symptoms  of  Acute  Gastritis). 

Diagnosis.— A  correct  diagnosis  requires  a  careful  and 
accurate  anamnesis.  This  condition  is  often  mistaken  for 
some  acute  abdominal  disease,  such  as  peritonitis,  acute 
gastritis  or  intestinal  obstruction.  However,  by  carefully 
observing  the  symptoms,  and  by  palpation,  together  with 
the  anamnesis,  the  diagnosis  is  usually  made  without  much 
difficulty. 

Prognosis.— In  those  cases,  due  to  overloading,  the  prog- 
nosis is  considered  favorable;  when  due  to  other  causes  it  is 
unfavorable  as  complications  are  liable  to  ensue  which  often 
terminate  fatally. 

Treatment.—  Medical.— When  due  to  overloading  the 
stomach  or  from  foreign  material,  emetics  are  indicated 
early  to  remove  it.  Apomorphin  (0.005-0.01)  should  be 
administered  subcutaneously,  and  the  stomach  carefully 
kneaded  to  break  up  the  food  masses  and  to  mix  the  con- 
tents with  the  secretions  so  that  they  will  be  more  easily 
ejected.  After  the  material  has  been  removed  by  vomit- 
ing it  is  advisable  to  administer  sodium  bicarbonate  solu- 
tion (2  per  cent.)  to  remove  irritating  material  from  the 
surface  of  the  mucous  membrane.  (See  Treatment  of 
Acute  Gastritis).  In  cases  where  there  is  a  lack  of  tone  in 
the  muscular  walls  from  pressure  by  retained  food  masses, 
gas,  etc.,  or  defective  nervous  control  of  the  muscle,  the 
administration  of  strychnin  sulphate  (0.0005-0.001  daily), 
or  tincture  of  nux  vomica  (0.3-0.6  twice  daily)  has  been 
found  advantageous. 

Surgical.— In  severe  cases  where  the  food  particles  cannot 
be  removed  by  emesis,  or  where  foreign  material  is  present, 
it  is  advisable  to  remove  it  by  performing  gastrotomy.  (See 
Surgical  Treatment  of  Foreign  Bodies  in  the  Stomach). 

CHRONIC  DILATATION  OF  THE  STOMACH. 

Etiology.— While  not  common  in  small  animals  it  is  occa- 
sionally observed,  and  consists  of  a  dilatation  of  the 


CHRONIC  DILATATION  OF  THE  STOMACH        155 

stomach,  which  is  very  commonly  produced  by  food  masses 
remaining  in  the  stomach  for  a  long  period,  producing  press- 
ure on  the  walls  of  the  stomach  leading  to  a  lack  of  tone 
in  the  muscular  wall.  This  allows  further  accumulation  of 
fluids  and  gases  from  the  fermentation  of  the  food  contained 
and  consequently  the  stomach  becomes  dilated.  In  some 
individual  animals  the  walls  of  the  stomach  are  relatively 
weak,  and  after  eating,  the  food  will  remain  in  the  stomach 
for  too  long  a  period,  and  gradually  produce  a  chronic  dila- 
tation. Many  of  the  causes  enumerated  under  acute  dilata- 
tion, if  continued  for  some  time,  will  result  in  the  chronic 
condition. 

Stenosis  of  the  pylorus  is  one  of  the  most  frequent  causes 
of  this  condition.  The  etiological  factors  producing  the 
stenosis  are  the  following:  Spasm,  gastric  ulcer,  erosions 
of  the  mucous  membranes  resulting  in  cicatrix  formation. 
Foreign  bodies  which  may  remain  in  the  stomach  for  a 
long  period,  and  produce  by  their  constant  irritation  hyper- 
trophy of  the  mucosa  of  the  pylorus,  resulting  in  a  nar- 
rowing or  complete  closing  of  the  pyloric  opening.  Tumors, 
either  malignant  or  benign,  extending  into  the  pylorus. 
Tumors,  outside  of  the  stomach  (carcinomas,  sarcomas) 
and  associated  with  adjacent  organs  or  tissues.  These  by 
producing  pressure  upon  the  duodenum  will  narrow  the 
lumen  and  result  in  a  stenosis.  Inflammation  in  organs 
adjacent  to  the  stomach  as  the  liver  and  pancreas;  or  omental 
adhesions  which  occur  commonly  after  abdominal  opera- 
tions, or  by  being  injured,  as  blows  to  the  abdomen  or  being 
run  over  by  vehicles.  The  stenosis  which  is  produced  by 
the  above  causes  will  interfere  with  the  passage  of  the  food 
from  the  stomach  where  it  remains  too  long  eventually 
leading  to  chronic  dilatation.  In  old  dogs  it  frequently 
results  from  chronic  obstipation.  Further,  debilitating  dis- 
eases will  often  produce  it  by  interfering  with  the  nervous 
control  of  the  stomach. 

Pathology.— The  stomach  is  much  enlarged  and  in  many 
cases  distorted.  When  due  to  stenosis  or  obstruction  to  the 
pylorus,  the  stomach  walls  are  greatly  thickened.  The  mus- 
culature is  hypertrophic  and  the  mucous  membrane  is  often 


156  DISEASES  OF   THE  STOMACH 

several  times  its  normal  thickness,  with  all  the  evidences  of 
a  chronic  inflammation.  When  no  stenosis  exists,  the  dila- 
tation being  produced  by  other  causes,  the  muscular  wall  is 
very  thin  and  atrophic.  In  some  cases  the  mucous  mem- 
brane shows  areas  of  atrophy  and  hypertrophy  alternating. 
The  interstitial  tissue  is  often  infiltrated  with  fibrous  tissue. 

Symptoms.— In  dogs  the  symptoms  are  very  similar  to 
chronic  gastritis.  There  is  a  partial  or  complete  loss  of  appe- 
tite, intense  thirst,  especially  if  the  pylorus  is  obstructed, 
the  patients  drinking  large  amounts  of  water  which  is  after- 
ward vomited. 

Constipation  is  also  quite  marked  in  most  cases  of  chronic 
dilatation.  As  no  water  can  pass  from  the  stomach  to  the 
intestines,  the  contents  of  the  intestinal  tract  become  hard 
and  dry  to  be  passed  with  difficulty,  or  retained  as  a  hard 
mass  in  the  posterior  part  of  the  bowels.  When  dilatation 
occurs  without  stenosis  of  the  pylorus  large  amounts  of  water 
will  pass  into  the  intestinal  tract  producing  diarrhea,  which 
may  alternate  with  constipation.  Emaciation  is  usually 
quite  marked,  especially  in  advanced  cases,  because  no 
nutriment  can  be  absorbed.  In  some  cases  where  there  is 
only  a  partial  stenosis  the  emaciation  will  be  more  gradual, 
as  some  food  will  be  passed  to  the  small  intestines.  Severe 
pain,  the  animal  often  showing  excitable  symptoms,  howling, 
etc.,  is  shown  a  short  period  after  eating,  due  to  the  par- 
ticles of  food  passing  through  the  narrowed  lumen  of  the 
pylorus.  Where  no  stenosis  exists  there  is  but  little  pain. 
Vomiting  is  a  constant  symptom,  especially  in  obstruction 
of  the  pylorus,  and  usually  occurs  shortly  after  feeding.  The 
patient  will  sometimes  eat  the  ejected  mass  again  only  to 
repeat  the  act  of  vomiting.  This  symptom  is  quite  charac- 
teristic coming  as  it  does  shortly  after  eating  and  continuing 
in  some  cases  in  the  same  manner  for  days  or  even  weeks. 

Gradually  the  animals  become  weak,  anemic,  the  tempera- 
ture subnormal,  and  die  from  inanition. 

Palpation  over  the  region  of  the  stomach  will  often  reveal 
the  enlarged  organ  with  its  contents;  percussion  gives  a 
tympanitic  sound. 


ULCERATION  OF   THE  STOMACH  157 

Diagnosis.— Diagnosis  is  rather  difficult  in  most  cases. 
The  chronic  course,  the  characteristic  symptoms,  and  the 
findings  of  an  explorative  laparotomy  suffice  to  make  the 
diagnosis. 

Prognosis.— The  prognosis  should  be  carefully  guarded 
until  the  causes  and  condition  of  the  stomach  are  thoroughly 
understood.  Complete  recovery  is  possible  in  both  forms  of 
this  disease,  provided  the  wall  of  the  stomach  is  not  perma- 
nently damaged  and  the  general  condition  of  the  animal 
capable  of  improvement.  However,  in  stenosis  of  the  pylorus, 
it  should  always  be  considered  unfavorable  when  tumors  are 
present. 

Treatment.—  Dietetic.— Small  amounts  of  easily  digested 
food  are  to  be  given  at  short  intervals  during  the  day  rather 
than  large  quantities  at  long  intervals.  In  some  cases  where 
vomiting  is  persistent,  rectal  feeding  should  be  employed 
giving  albumen  or  predigested  foods. 

Medical.— In  dilatation  accompanied  by  lack  of  tone  of 
the  muscle  stomachic  tonics,  such  as  tincture  of  nux  vomica 
(0.3-0.6  twice  daily)  or  strychnin  sulphate  (0.0005-0.001), 
may  be  used. 

Massaging  or  kneading  the  abdominal  wall  over  the 
stomach  is  a  valuable  adjunct  to  increase  the  muscular  tone. 
When  stenosis  exists  surgical  interference  is  the  only  thing 
that  will  give  relief;  it  should  be  resorted  to  as  early  as 
possible.  (See  Gastroduodenostomy) . 

ULCERATION  OF  THE  STOMACH. 
Ulcus  Venlriculi. 

Definition.— This  condition  is  a  more  or  less  progressive 
destruction  through  necrosis  beginning  in  the  mucosa  and 
often  extending  to  and  through  the  deeper  layers  of  the 
stomach  wall.  True  ulcers  appear  only  where  the  gastric 
juice  flows.  They  are  found  in  the  dog  at  the  extreme  lower 
end  of  the  esophagus,  in  the  stomach  wall  itself,  and  in  a 
portion  of  the  duodenum  above  the  opening  of  the  bile  duct. 
The  ulcerations  may  be  acute  or  chronic.  Sometimes  a  ten- 
dency to  cicatrization  and  healing  is  shown.  At  the  point 


158  DISEASES  OF   THE  STOMACH 

where  the  stomach  tissue  is  destroyed  an  oval  or  round 
opening  or  depression  with  irregular  margins  appears.  The 
more  chronic  the  process  the  greater  the  irregularity  in 
outline. 

Etiology.— Simple  ulceration  of  the  stomach  is  due  to  a 
destruction  of  the  gastric  epithelium  caused  chiefly  by  a  dis- 
turbance in  blood  circulation  in  the  stomach  and  hyperacidity 
of  the  gastric  juice.  It  is  often  brought  about  by  inflammation 
of  the  mucosa  or  hemorrhages,  resulting  from  poisonous  sub- 
stances, caustics,  drugs  (when  administered  in  too  concentrated 
form);  sharp  foreign  bodies;  during  the  course  of  infectious 
diseases  (distemper,  etc.),  or  from  an  invasion  by  the  Bacillus 
necrophorus  (puppies  and  kittens),  or  other  local  infections. 
General  infection  (pyernia)  may  too  be  a  causative  factor. 
These  infections  produce  an  extensive  inflammation  of  the 
mucosa,  often  leading  to  a  disturbance  in  the  circulation, 
interfering  with  nutrition,  and  ultimately  leading  to  an  ulcera- 
tive  process.  Wounds  of  the  mucous  membrane  from  external 
violence,  partial  rupture  of  the  stomach  walls  or  parasitic 
invasion  are  causes.  They  are  often  contributory  to  the 
beginning  of  the  ulcerative  process.  Embolism  is  also  a  cause, 
producing  infarcts  in  the  mucosa  and  submucous  tissue. 
Hemorrhagic  erosions  and  hemorrhages  occurring  and 
associated  with  chronic  diseases  of  the  heart,  liver  or  kidneys 
are  probable  causes.  Hyperacidity  may  produce  gastric 
ulcer  when  from  any  cause  the  mucous  membrane  is  injured, 
the  acid  acting  upon  the  ends  of  exposed  vessels  by  contract- 
ing them,  thus  inducing  local  anemia  and  eventually  necrosis. 

Pathology.— The  typical  ulcer  is  round  or  oval,  extending 
more  or  less  deeply  into  the  mucous  membrane  or  the  wall 
of  the  stomach.  They  have  a  characteristic  funnel  shape, 
and  when  acute  form  a  rather  regular  outline,  while  in  ulcers 
of  long  standing  the  margins  become  very  irregular.  When 
chronic  ulcers  are  present,  the  entire  wall  is  usually  thickened. 
Sometimes  a  coalescence  of  the  ulcerations  or  erosions  occurs. 
When  ulceration  becomes  severe  and  the  submucosa  is 
involved,  adhesions  exist  with  adjacent  organs. 

Symptoms.— In  quite  a  large  percentage  of  cases  of  mild 
ulceration  or  erosions  the  symptoms  are  never  observed 


ULCERATION  OF  THE  STOMACH  159 

during  the  life  of  the  animal.  In  more  advanced  ulcerations 
the  symptoms  are  often  very  similar  to  chronic  gastritis 
(see  Chronic  Gastritis).  Bloody  vomiting  is  a  characteristic 
symptom.  The  amount  of  blood  ejected  varies  depending 
upon  the  extent  of  the  injury  to  the  vessels  done  by  the  ulcera- 
tive  process.  This  condition  usually  persists  for  a  long  time 
with  exacerbations  and  remissions.  When  the  ulcer  perfo- 
rates the  wall  of  the  stomach  symptoms  of  acute  peritonitis 
develop  rapidly  and  a  fatal  termination  soon  follows. 

General  symptoms  of  emaciation,  weakness,  and  disturb- 
ances of  the  intestinal  tract  are  usually  observed. 

Diagnosis.— An  accurate  diagnosis  is  very  difficult,  and  can 
only  be  made  by  a  careful  observation  of  the  symptoms. 
When  ulceration  is  suspected  laparotorny  can  be  performed 
(see  Foreign  Bodies  of  the  Stomach)  to  determine  the  condi- 
tion of  the  stomach.  However,  when  the  ulcerative  process 
is  slight  or  only  erosions  are  present,  even  this  examination 
may  not  suffice  for  diagnosis. 

Prognosis.— The  prognosis  is  always  unfavorable,  as  only 
the  advanced  cases  are  recognized  clinically. 

Treatment.—  Dietetic.— Only  small  quantities  of  easily 
digested  food  (beef  broth,  milk,  small  amounts  of  lean  meat 
finely  divided)  should  be  allowed,  as  there  is  danger  of  the 
•wall  rupturing  at  the  point  of  ulceration. 

Medical.— Astringents  and  hemostatics  are  indicated  (bis- 
muth subnitrate  0.3-0.5,  or  silver  nitrate  0.05-0.1  well 
diluted  in  distilled  water) .  These  preparations  can  be  admin- 
istered two  or  three  times  daily,  depending  upon  the  action 
desired.  Where  severe  hemorrhage  takes  place,  adrenalin 
chlorid  (1.0-2.0  of  a  1-1000  sol.)  may  be  given  several 
times  daily  until  the  hemorrhage  stops.  To  neutralize  the 
acid  secretions  in  the  stomach  Carlsbad  salts  (2.0-4.0)  can 
be  used  twice  daily.  In  cases  where  vomiting  is  persistent 
small  doses  of  tincture  of  opium  (0.2-0.5)  are  administered 
every  two  hours  until  vomiting  ceases. 

Surgical.— In  some  cases  where  medical  treatment  does  not 
afford  relief,  laparotomy  should  be  performed  (see  Foreign 
Bodies  of  the  Stomach)  and  the  ulcerated  area  extirpated 
(see  Gastrotomy,  under  Foreign  Bodies  of  the  Stomach). 


160  DISEASES  OF   THE  STOMACH 

HEMATEMESIS. 

Definition.— Hematemesis  is  the  vomiting  of  blood.  It  is 
merely  a  symptom.  The  hemorrhage  does  not  always  come 
from  the  stomach  itself,  but  from  structures  contiguous  to 
the  stomach.  In  small  animals  hematemesis  is  much  more 
common  than  is  usually  recognized,  but  unless  large  quanti- 
ties of  blood  are  vomited,  it  escapes  notice.  Often  scant 
hemorrhages  go  unrecognized,  the  determination  of  which 
would  be  valuable  for  the  diagnosis  of  some  diseases. 

Etiology. — In  hematemesis  there  may  be  no  anatomical 
lesions  on  the  mucous  membrane  (diapedesis) ;  or  the  lesions 
may  be  very  small  but  numerous  and  the  hemorrhages 
copious  coming  from  a  large  surface  of  the  mucosa.  On  the 
other  hand  the  lesion  in  the  mucosa  may  be  quite  marked 
(rhexis;  ulcer,  etc.).  In  the  dog  hematemesis  is  quite  common 
and  has  the  following  causes: 

Local  causes:  Ulcerations  on  the  mucosa;  erosions  on  the 
mucosa;  acute  and  chronic  gastritis;  tumors;  trauma  which 
may  be  direct  (foreign  bodies,  injury  from  stomach  sound) 
or  indirect  (straining  during  vomiting,  stomach  operations) ; 
chemicals  (poisons,  purgatives,  emetics). 

Indirect  local  causes  are  further:  Obstruction  to  the  portal 
circulation;  pressure  on  the  portal  vein;  thoracic  diseases, 
disturbing  circulation ;  organic  heart  lesions,  etc. 

Hematemesis  may  occur  also  from  many  general  causes 
which  produce  at  the  same  time  hemorrhage  from  several 
of  the  mucous  membranes.  The  following  are  the  most 
common  conditions:  Septicemia;  autotoxic  conditions, 
uremia,  etc.;  blood  dyscrasias  and  diseases,  hemophilia, 
scurvy,  pernicious  anemia,  leukemia.  The  blood  may  have 
its  origin  outside  the  stomach  and  come  from  contiguous 
abscesses  rupturing  the  stomach  wall,  or  from  ulcers  and 
fistula1  which  may  open  a  suppurating  tract  into  the  stomach. 

Hematemesis  also  occurs  during  the  course  of  infectious 
diseases  (distemper,  rabies). 

Pathology. —The  pathological  findings  depend  upon  the 
amount  of  the  hemorrhage.  When  the  hemorrhages  prove 
fatal  there  is  a  general  pallor  of  all  the  viscera;  where  the 


HEMATEMESIS  161 

hemorrhages  have  been  slow  and  continuous  fatty  degenera- 
tions of  the  heart,  liver,  kidneys,  gland  cells  are  observed. 
The  original  cause  will  in  part  determine  the  nature  of  the 
pathological  changes.  The  mucous  membrane  of  the  gastro- 
intestinal tract  is  pale,  and  remains  of  the  hemorrhage  will 
be  noticed  along  its  course,  which  is  of  a  dark  color  and  more 
or  less  tarry.  At  the  seat  of  the  hemorrhage  will  be  found 
eroded  vessels,  and  .sometimes  imperfect  clot  formation. 
Other  lesions  found  are  those  of  ulceration,  foreign  bodies, 
depending  upon  the  original  cause  of  the  hemorrhage. 

Symptoms.— These  depend  very  largely  upon  the  amount 
of  hemorrhage  and  rapidity  with  which  it  flows.  When 
the  amount  of  hemorrhage  is  small  the  symptoms  may  be 
entirely  overlooked.  The  vomited  blood  may  be  only  in 
small  quantities  often  poorly  mixed  with  the  ejected  food. 
The  color  of  the  blood  depends  upon  the  amount  and  length 
of  time  remaining  in  the  stomach.  When  fresh,  the  color  is 
bright  and  the  cells  are  unchanged;  when  retained  in  the 
stomach  some  time  before  it  is  ejected,  it  is  dark,  the  oxy- 
hemoglobin  being  changed  to  hematin,  and  resembles  coffee 
grounds.  A  microscopic  examination  of  the  ejected  mass 
will  at  once  reveal  the  presence  of  large  numbers  of  red  cor- 
puscles unless  the  blood  has  been  retained  in  the  stomach 
long  enough  for  the  red  corpuscles  to  become  entirely  dis- 
integrated. 

When  severe  hemorrhages  take  place  in  the  stomach,  some 
of  the  blood  will  pass  into  the  intestinal  tract  to  be  passed 
out  with  the  feces.  The  feces  will  be  of  a  dark  tarry  consist- 
ency, with  a  disagreeable  odor.  If  examined  the  blood 
pigment  will  be  found  in  large  quantities. 

General  symptoms  of  internal  hemorrhage  are  noticed  in 
the  more  severe  cases.  The  mucous  membranes  suddenly 
become  pale  and  colorless,  the  pulse  very  weak  and  often 
imperceptible,  dyspnea  and  general  weakness  appear.  If 
repeated  hemorrhages  do  not  result  fatally  the  patient 
suffers  from  chronic  anemia. 

Diagnosis.— This  depends  upon  the  presence  of  the  blood 
mixed  with  the  vomitus.  Tare  should  be  taken  in  making 
the  diagnosis  in  the  dog  as  they  often  eat  large  quantities  of 
11 


162  DISEASES  OF   THE  STOMACH 

clotted  blood,  or  lick  blood  from  bleeding  surfaces  which 
may  produce  vomiting.  When  this  is  suspected  the  general 
symptoms  should  be  carefully  considered  and  a  careful 
anamnesis  obtained  if  possible. 

A  microscopic  examination  of  the  contents  from  the 
stomach  and  bowels  will  in  most  cases  assist  in  arriving  at 
an  accurate  diagnosis.  It  may  be  differentiated  from  hemor- 
rhage of  the  lungs  by  the  presence  of  food  particles,  and 
the  absence  of  air  mixed  with  the  material,  and  from  the 
fact  that  it  usually  has  an  acid  reaction  from  contact  with  the 
gastric  juice. 

Prognosis.— This  depends  very  largely  upon  the  cause,  and 
to  a  less  extent  upon  the  severity  of  the  hemorrhage.  When 
resulting  from  wounds  in  the  mucosa  when  not  too  extensive 
it  should  be  considered  favorable.  However,  when  due  to 
ulceration  of  the  mucosa,  or  resulting  from  general  causes  the 
prognosis  is  unfavorable. 

Treatment.— The  early  indication  in  the  treatment  is 
to  keep  the  animal  in  a  quiet  place  free  from  all  excite- 
ment or  noise.  The  administration  of  cold  water  (ice  water) 
internally  or  cold  applications  to  the  epigastrium  in  the 
form  of  cold  water  or  ice  are  beneficial.  To  control  the 
hemorrhage  when  severe,  adrenalin  chlorid  solution  (1.5-2.0 
of  1-1000  solution),  or  ergotin  (0.2-1.0)  subcutaneously 
should  be  given  every  two  or  three  hours  until  the  hemor- 
rhage stops.  Gelatin  given  via  the  mouth  has  been  highly 
recommended  for  the  same  purpose.  In  less  severe  cases 
mild  astringents  (tannic  acid,  lead  acetate,  tannoform,  alum) 
are  to  be  used.  Wrhere  general  weakness  is  well  marked 
subcutaneous  injections  of  strychnin  sulphate  (0.0005-0.001), 
or  caffein  citrate  (0.06-0.19)  are  to  be  used  to  stimulate  the 
heart  action,  and  as  a  general  stimulant.  Saline  infusions 
given  as  rectal  injections,  intravenous  injections,  or  intra- 
peritoneally  are  indicated  in  severe  hemorrhages  to  replace 
the  loss  of  blood  in  the  body.  When  hematemesis  is  due  to 
other  diseases,  the  cause  should  be  determined  and  treat- 
ment applied  accordingly. 

All  food  should  be  withheld  for  at  least  two  days,  and  then 
allowed  only  in  small  quantities.  Milk  or  beef  broth  is 
useful  in  this  regard. 


PARASITES  IN  THE  STOMACH  163 


PARASITES  IN  THE  STOMACH. 

The  parasites  that  develop  in  the  stomach  of  the  dog  are 
very  rare.  The  Spiroptera  sanguinolenta,  a  small  blood  red 
worm  from  5  to  8  cm.  long,  is  the  most  common.  It  forms 
small,  tumor-like  masses  in  the  mucosa.  Occasionally  the 
larvae  of  the  Gastrophilis  intestinalis  are  found  attached  to  the 
mucous  membrane.  Ascarides  and  teenia  commonly  migrate 
from  the  intestines.  Tsenia  are  often  found  in  the  stomach 
of  the  cat,  the  Taenia  tseniseformis  being  the  most  common. 
The  Ollulanus  tricuspis,  however,  is  the  only  parasite  proper 
to  the  stomach  of  the  cat. 

The  adult  Ollulanus  tricuspis  is  about  1  mm.  long  and  has 
three  points  at  the  caudal  extremity.  The  adult  worm  lives 
in  the  gastric  mucous  membrane  and  when  present  in  large 
numbers,  seriously  interferes  with  the  function  of  the  mem- 
brane. The  embryos  are  quite  large  compared  with  the 
adult  parasite.  Some  of  these  embryos  are  passed  with  the 
feces  while  others  burrow  through  the  walls  of  the  intestines 
and  wander  to  various  parts  of  their  host,  particularly  the 
pleura,  diaphragm,  liver  and  lung,  wrhere  they  form  cysts. 
When  the  free  embryos  are  ingested  by  rodents  they  migrate 
into  the  muscles  and  become  encysted.  It  is  probable  that 
their  development  is  completed  in  the  digestive  canal  of  the 
cat  that  feeds  upon  the  infested  rodent. 

Rabbits  are  chiefly  infested  with  the  Strongylus  strigosus, 
often  found  in  large  numbers,  and  give  rise  to  a  fatal  anemia. 
This  parasite  is  8  to  16  mm.  long,  body  blood  red,  filiform 
and  transversely  striated. 

The  parasites  most  common  in  the  anterior  portion  of  the 
digestive  canal  of  birds  are  the  Dispharagus  spiralis,  Disphar- 
agus  nasutus  and  the  Trichosomum  contortum.  The  dis- 
pharagi  are  from  7  to  9  mm.  long  and  the  trichosome  12  to 
17  mm.  and  are  found  either  entirely  embedded  in  the  mucous 
membrane  or  fixed  in  it  by  one  extremity  and  the  other 
floating  free  in  the  cavity  of  the  organ.  The  Trichosomum 
contortum  is  frequently  found  in  adjacent  structures,  but 
is  common  in  the  walls  of  the  esophagus. 


164  DISEASES  OF  THE  STOMACH 

Symptoms.— The  parasites  which  are  proper  to  the  stomach 
of  small  animals  and  to  the  anterior  part  of  the  digestive 
canal  of  birds  do  not  as  a  rule  produce  any  marked  symptoms 
unless  present  in  very  large  numbers.  The  Spiroptera 
sanguinolenta  of  the  dog  may  give  rise  to  a  chronic  gastritis 
with  frequent  vomiting,  an  irregular  appetite  and  resulting 
emaciation.  The  tumor-like  masses  in  which  the  parasites 
live  may  perforate  the  peritoneum  and  occasion  a  fatal  peri- 
tonitis. Large  numbers  of  the  Ollulanus  tricuspis  in  the  cat's 
stomach  cause  a  thickening  and  ecchymosed  condition  in 
the  mucous  membrane  with  severe  gastric  disturbance.  As 
the  larvae  of  this  parasite  migrate  into  the  adjacent  tissues, 
they  can  produce  extensive  inflammatory  processes  and  give 
rise  to  pleuritis,  peritonitis,  bronchitis,  etc.  The  Strongylus 
strigosus  produces  a  severe  anemia  in  rabbits  by  abstracting 
blood  from  the  mucous  membrane  of  the  stomach,  and  by 
so  doing  produces  a  disturbance  in  the  function  of  the  stomach 
with  inanition  as  a  result.  In  warren  rabbits  where  they  are 
continually  subjected  to  reinfection,  this  anemia  often 
terminates  fatally,  at  times  being  epizootic  in  its  extent. 

The  parasites  of  birds  produce  the  most  serious  disturb- 
ance by  burrowing  in  the  walls  of  the  esophagus  and  crop. 
The  food  when  swallowed  becomes  impacted  through  loss 
of  propelling  action  of  the  organ  and  dilatation  results  often 
with  fatal  termination. 

Diagnosis. — An  accurate  diagnosis  of  the  stomach  parasites 
of  the  dog  and  cat  is  difficult.  A  microscopical  examination 
of  the  feces  and  vomitus  for  the  larva?  may  reveal  their 
presence.  When  the  general  symptoms  are  indicative  of 
parasitism  laparotomy  and  possibly  gastrotomy  should  be 
performed,  and  a  direct  examination  of  the  tumor-like  masses 
made.  In  rabbits  and  birds,  as  several  are  usually  affected,  a 
postmortem  examination  of  one  or  two  of  the  most  typical 
cases  is  recommended. 

Prognosis.— Unfavorable  in  all  cases  of  severe  infestation. 
Mild  cases  in  dog,  cat  and  rabbit  often  recover  spontaneously 
or  with  ordinary  treatment.  In  birds,  however,  the  injury 
to  the  walls  soon  leads  to  dilatation  and  quite  often  to  a 
fatal  termination. 


NEOPLASMS  IN   THE  STOMACH  165 

Treatment.— No  satisfactory  treatment  can  be  given  for 
those  parasites  living  within  the  tumor  masses  or  burrows 
in  the  mucous  membrane.  When  such  parasites  are  diag- 
nosed, all  the  affected  individuals  should  be  removed  and  a 
thorough  cleaning  given  all  the  houses,  runways,  and  grounds 
to  which  they  have  had  access.  (For  ascarides  and  taenia  see 
Parasites  of  the  Intestines.) 


NEOPLASMS  IN  THE  STOMACH. 

Tumors  in  the  stomach  especially  primary  growths  are 
very  seldom  found  in  small  animals.  Occasionally  secondary 
carcinomas  or  sarcomas  occur. 

Symptoms.— The  symptoms  observed  are  very  similar  to 
chronic  gastritis  (see  Chronic  Gastritis).  The  growth  of  the 
tumor  is  often  sufficient  to  increase  the  size  of  the  abdomen 
and  can  usually  be  palpated  through  the  abdominal  walls. 
Other  symptoms  are  persistent  vomiting,  icterus,  and  loss 
of  appetite.  When  a  tumor  of  the  stomach  is  suspected 
laparotomy  should  be  performed  and  a  direct  examination 
made. 

Prognosis. — Unfavorable. 

Treatment.— No  attempt  should  be  made  to  operate  malig- 
nant growths.  Tumors  involving  the  anterior  part  of  the 
stomach  are  inoperable  owing  to  the  location  and  close  attach- 
ment of  the  stomach.  Fortunately,  however,  tumors  of  the 
stomach  usually  involve  the  pyloric  end,  and  in  such  cases 
gastroduodenostomy  should  be  performed  removing  the 
entire  part  involved.  Gastroduodenostomy  must  be  per- 
formed with  considerable  care  to  prevent  infection  from 
the  stomach  contents  and  hemorrhage  from  the  large  vessels, 
and  also  to  so  place  the  ligatures  as  to  avoid  cutting  off 
blood  supply  from  any  part  of  the  stomach  not  removed. 
The  modus  operandi  is  as  follows:  Thoroughly  anesthetize 
the  animal  and  secure  in  the  dorsal  position.  Cover  the 
field  of  operation  with  sterile  cloths  and  provide  plenty  of 
suture  material  (linen  machine  cord  No.  40)  and  medium- 
sized,  straight  sewing  needles  (Emmet's  bowel  needles). 
Perform  laparotomy  at  the  median  line  from  the  xiphoid 


166  DISEASES  OF   THE  STOMACH 

cartilage  to  the  umbilical  scar.  Grasp  the  stomach  and  draw 
it  up  through  the  opening.  Ligate  the  right  and  left  branches 
of  the  gastric  arteries,  the  splenic  and  the  gastrohepatic 
arteries.  The  location  of  the  ligatures  along  the  arteries 
depends  on  the  location  of  the  excision.  In  all  cases  the 
ligatures  must  be  close  to  the  excision  to  avoid  having  an 
area  of  the  stomach  left  without  blood  supply.  Place  a  gas- 
trectomy  forceps,  the  jaws  protected  with  rubber  tubing, 
across  the  stomach  just  back  of  the  point  of  each  excision, 
and  two  others  across  the  part  to  be  removed  far  enough 
from  the  others  to  allow  cutting  between  them  with  shears. 
The  forceps  protect  against  hemorrhage  and  escape  of  con- 
tents while  the  latter  prevent  escape  of  material  contained 
in  the  part  to  be  removed.  Remove  by  cutting  between  the 
clamp  with  scissors  and  suture  both  ends  with  continuous 
suture  over  and  over  the  cut  edges  to  control  hemorrhage, 
and  invert  the  ends  by  putting  in  Lembert  sutures.  Remove 
the  forceps  and  take  up  a  part  of  the  anterior  wall  of  the 
stomach  and  apply  the  forceps,  having  the  part  that  projects 
through  the  forceps  about  two  inches  long  by  one-half  inch 
through.  Do  the  same  with  the  duodenum  about  three 
inches  from  the  pylorus.  Place  the  forceps  close  together 
and  apply  sutures  through  the  muscular  coat  close  to  the 
lower  jaw  of  each  forceps,  and  do  not  cut  off  the  suture. 
Then  make  an  incision  in  the  stomach  close  to  the  line  of 
sutures  and  one  in  the  duodenum  to  correspond  with  the  one 
in  the  stomach.  Then  with  a  new  suture  join  the  distal 
edges  of  the  wound  with  Council's  sutures,  the  forceps  being 
loosened  but  left  in  place  to  support  the  stomach.  These 
latter  sutures  invert  the  cut  edges  and  the  first  suture  can 
now  be  continued  over  the  Connell  suture  as  a  Lembert 
suture.  Return  the  organs  and  suture  the  laparotomy 
wound.  After  forty-eight  hours  feed  liquid  food  for  several 
days. 


CHAPTER   IX. 
DISEASES  OF  THE  INTESTINES. 

Examination.— The  intestines  can  be  easily  palpated 
through  the  abdominal  wall  in  most  small  animals,  when 
they  are  not  too  fat,  and  this  greatly  assists  in  making  an 
accurate  diagnosis,  especially  of  foreign  bodies,  fecal  accumu- 
lation (coprolith),  etc.  This  is  best  done  by  placing  the 
animal  in  the  standing  position  using  both  hands,  one  on 
either  side  of  the  abdomen.  When  necessary  to  make  a  more 
careful  examination,  as  for  perforating  wounds,  volvulus, 
etc.,  explorative  laparotomy  should  be  employed.  The 
intestines  are  best  reached  by  making  the  incision  at  the 
median  line  in  the  middle  of  the  distance  from  the  xiphoid 
cartilage  to  the  anterior  border  of  the  pelvis,  and  of  sufficient 
size  to  permit  of  a  thorough  examination  of  the  entire  length 
of  the  intestine.  The  Roentgen  rays  can  be  employed  to 
detect  foreign  bodies. 

The  feces  should  be  carefully  examined  for  the  following: 
Frequency,  color,  odor,  quantity,  consistency,  presence  of 
blood,  parasites  or  their  ova,  mucus,  foreign  bodies,  undi- 
gested food.  The  peristalsis  is  important  and  can  be  exam- 
ined by  placing  the  animal  on  its  side,  covering  the  abdomen 
with  a  towel  or  cloth  and  applying  the  ear.  The  phonendo- 
scope  is  of  great  assistance  for  this  purpose.  Percussion  is 
important  in  differentiating  accumulations  of  fluid  or  gas 
in  the  abdomen  or  intestines. 

ENTERITIS. 

Two  forms  of  enteritis  are  recognized  in  small  animals, 
viz.:  (a)  Acute,  and  (6)  chronic. 

Acute  Enteritis.— Definition.— This  is  a  catarrhal  inflamma- 
tion of  the  mucous  membrane  of  the  small  intestine,  as  well 


168  DISEASES  OF   THE  INTESTINES 

as  the  upper  portion  of  the  large  bowel.  In  small  animals  it 
is  impossible  from  a  clinical  standpoint  to  recognize  the 
condition  as  affecting  different  parts  of  the  bowels  as: 
Duodenitis,  ileitis,  jejunitis,  etc.  P^nteritis  very  frequently 
accompanies  acute  gastritis,  the  causes  producing  acute 
gastritis  often  extending  into  the  intestines. 

Etiology.— The  etiology  is  in  many  respects  similar  to  that 
of  acute  gastritis:  (a)  Foreign  bodies  which  irritate,  such 
as  sharp  pieces  of  bone,  needles,  pins,  etc.  These  when  swal- 
lowed pass  through  the  stomach  into  the  intestines,  often 
producing  extensive  irritation  to  the  mucosa,  resulting  in  an 
acute  inflammation.  Enteritis  may  result  also  from  opera- 
tions, such  as  laparotomy  when  the  bowels  are  roughly 
handled,  rectal  injections  and  manipulations,  etc.  Powdered 
glass  is  sometimes  given  intentionally  to  small  animals,  and 
it  produces  a  very  severe  form  of  enteritis. 

(6)  Chemical  substances  (carbolic  acid,  arsenic,  phos- 
phorus, mercury,  etc.)  produce  a  very  severe  form  of  enteritis 
by  their  corrosive  action  on  the  mucous  membrane.  Chemical 
irritants  contained  in  food  when  eaten  by  the  animals  will 
produce  the  same  condition.  Sometimes  excessive  quantities 
of  foods,  or  digestive  disturbance  may  occasion  fermentation 
in  the  intestinal  tract  and  the  formation  of  irritants  that 
directly  excite  an  inflammatory  condition.  Also  foods  (meat, 
fish)  may  contain  preformed  toxic  bodies,  such  as  ptomaines 
or  other  products  of  bacterial  action,  which  may  occasion 
violent  inflammation  of  the  bowels.  Cats  are  frequently 
affected  by  eating  fish  partially  decomposed.  Birds,  from 
eating  substances  containing  rather  large  quantities  of 
sodium  chlorid,  suffer  from  a  severe  form  of  inflammation 
of  the  bowels  as  the  result. 

(c)  Exposure  to  cold,  or  sudden  cooling  of  the  surface  of 
the  body  may  produce  an  enteritis  by  interfering  with  the 
innervation   and   circulation   in   the   intestinal   walls;   also 
taking  large  quantities  of  cold  water,  frozen  or  very  cold 
foods  will  induce  it. 

(d)  Bacteria  probably  rarely  cause  inflammation  of  the 
bowels  directly,  but  their  action  upon  the  intestinal  contents 
causing  fermentative  changes  are  causes  of  enteritis.     Ente- 


ENTERITIS  1G9 

ritis  is  an  essential  complication  in  certain  infectious  diseases 
(distemper,  enterohepatitis,  etc.).  , 

(e)  Severe  infestations  with  animal  parasites  can  produce 
acute  enteritis  by  the  irritant  action  of  the  parasites  upon 
the  mucosa  producing  congestion  and  in  some  cases  by 
attaching  themselves  to  the  membrane  or  burrowing  into  its 
walls.  The  severity  of  the  inflammation  produced  depends 
very  largely  upon  the  number  and  species  of  parasites  present. 
This  condition  is  observed  most  often  in  puppies  and  kittens. 
Acute  enteritis  also  occurs  secondarily  to  other  diseases, 
such  as  septicemia,  septicemic  diseases  of  birds,  peritonitis, 
coccidiosis  of  rabbits  and  birds,  etc. 

Pathology. — The  mucous  membrane  of  the  bowel  may  be 
involved  in  its  entire  length  with  almost  equal  severity,  but 
usually  certain  portions  are  more  seriously  affected  than 
others.  The  mucosa  is  swollen  and  reddened,  the  surface 
usually  covered  with  mucus,  which  may  be  tinged  with  blood, 
and  sometimes  the  submucosa  is  edematous  with  hemor- 
rhagic  extravasations.  The  lymphatic  follicles  are  enlarged 
and  project  out  from  the  mucosa  prominently  as  light  patches 
against  the  inflamed  surface  of  the  mucosa.  In  severe  cases 
pseudomembranous  or  diphtheritic  inflammations  of  the 
mucous  membrane  of  the  intestines  may  be  seen  occurring 
usually  secondary  to  infections  originating  elsewhere  or 
from  the  action  of  corrosive  poisons  which  are  very  common 
in  dogs  and  birds.  In  all  of  these  cases  the  mucous  mem- 
brane is  covered  with  an  extensive,  dirty  yellow  or  grayish 
deposit,  appearing  as  a  coating  over  the  surface  or  as  a 
firmly  attached  pseudomembrane.  This  pseudomembrane 
may  be  found  in  the  entire  length  of  the  bowel.  Areas  of 
the  necrosis  and  deep  ulceration  are  often  seen  where  the 
pseudomembrane  has  been  dislodged.  Hemorrhages  are 
often  found  under  and  from  the  mucosa,  the  blood  mixing 
with  the  intestinal  contents  forming  a  dark  red  mass.  The 
feces  are  very  thin  even  in  the  large  intestine  and  have  a 
disagreeable  odor.  The  mesenteric  lymph  glands  are  swollen 
and  edematous. 

Symptoms.— The  clinical  symptoms  in  enteritis  vary  with 
the  intensity  of  the  cause  and  the  part  of  the  intestinal  tract 


170  DISEASES  OF   THE  INTESTINES 

involved.  In  milder  cases  the  symptoms  are  those  of  diar- 
rhea due  to  functional  disturbances  of  the  bowels.  In  severe 
cases  the  symptoms  come  on  suddenly  and  are  of  great 
severity.  In  dogs  there  is  usually  constipation  in  the  early 
stages  followed  in  a  few  hours  by  diarrhea.  The  feces,  as  a 
rule,  are  liquid,  brownish  in  color  and  of  more  or  less  offen- 
sive odor,  depending  upon  the  extent  of  the  putrefactive 
changes  and  the  intensity  of  the  inflammation.  In  severe 
inflammations  due  to  corrosive  poisons,  etc.,  the  feces  are 
mixed  with  blood,  sometimes  passed  in  quite  large  quanti- 
ties, and  in  the  form  of  clots.  When  due  to  poisons,  the  odor 
of  the  poison  is  often  noticed  in  the  feces. 

Colicky  pains  are  noted  and  in  severe  cases  intense  abdom- 
inal pain  is  one  of  the  most  prominent  symptoms.  The 
abdominal  muscles  are  tense,  contracted,  often  giving  the 
animal  a  "tucked  up"  appearance.  In  severe  inflammation 
of  the  bowels  the  dog  will  often  lie  stretched  out  on  its 
abdomen,  showing  intense  pain  by  howling,  crying,  nervous- 
ness, etc.  Sometimes  the  nervous  symptoms  will  be  promi- 
nent enough  to  simulate  rabies. 

Vomiting  is  a  common  symptom  provided  the  stomach  is 
involved.  The  vomitus  usually  consists  of  food  particles, 
mucus,  blood,  bile,  and  in  rare  cases  feces  from  the  small 
intestines.  There  is  loss  of  appetite  except  in  the  very  mild 
cases.  Fever  is  more  or  less  high  in  the  early  stages,  while 
later  in  the  dog  it  becomes  subnormal.  The  temperature,  as  a 
rule,  cannot  be  depended  upon  to  determine  the  severity  of 
the  condition,  as  it  may  be  increased  in  slight  cases,  and  in 
severe,  be  normal  or  subnormal.  The  general  symptoms  are 
those  of  weakness,  in  proportion  to  the  degree  of  inflamma- 
tion, complete  prostration  or  collapse.  The  surface  of  the 
body  becomes  cold,  the  mucous  membranes  cyanotic,  there 
is  well  marked  dyspnea  and  a  weak,  rapid  pulse.  In  cats 
the  diarrhea  is  a  very  prominent  early  symptom.  The  feces 
are  liquid  and  often  mixed  with  blood.  Complete  prostra- 
tion takes  place  early  under  symptoms  of  dyspnea,  general 
weakness,  and  a  very  rapid  weak  pulse. 

In  birds  enteritis  begins  with  diarrhea.  The  feces  are 
of  a  thin  consistency,  of  a  yellowish  or  greenish  color,  and 


ENTERITIS  171 

very  offensive  odor.  The  feathers  in  the  region  of  the  cloaca 
become  soiled,  matted  together,  retaining  a  quantity  of  the 
feces  which  often  becomes  dried  and  forms  a  hard  mass 
around  the  anal  opening.  There  is  usually  loss  of  appetite, 
general  weakness,  the  wings  are  held  pendant  and  the  patient 
completely  prostrated.  In  the  more  severe  cases  due  to 
ptomaines,  toxins,  etc.,  the  symptoms  develop  very  rapidly, 
and  there  is  but  little  noticed  except  subnormal  temperature, 
narcosis  and  coma.  Death  occurs  in  a  large  percentage  of 
those  cases  due  to  ptomaines,  toxins,  etc. 

Diagnosis.— The  recognition  of  acute  enteritis  offers  no 
great  difficulties  in  most  cases.  The  anamnesis,  sudden 
onset,  abdominal  pain,  and  the  severe  diarrhea  are  all  quite 
characteristic.  Only  when  diarrhea  is  absent  would  the 
diagnosis  be  difficult.  A  careful  examination  should  always 
be  made  to  determine  if  possible  the  cause  of  the  enteritis, 
whether  it  is  a  primary  condition  or  secondary  to  some  other 
disease.  Examination  of  the  feces  should  be  made  both 
macro-  and  microscopically  to  determine  their  condition, 
the  presence  of  blood,  foreign  material,  or  of  parasites. 

Prognosis.— In  ordinary  cases  of  enteritis  the  prognosis  is 
usually  favorable.  However,  it  depends  very  largely  upon 
the  cause,  and  all  cases  should  be  considered  serious  until 
the  cause  can  be  determined.  "When  due  to  corrosive  poisons, 
ptomaines,  toxins,  etc.,  the  prognosis  should  be  considered 
very  unfavorable  depending  upon  the  amount  of  the  material 
ingested.  In  cats  the  prognosis  should  be  guarded  as  these 
animals  are  very  sensitive  to  intestinal  disturbances. 

Treatment.— Hygienic.— The  animals  should  be  placed  in 
a  warm,  dry  place  which  is  well  ventilated  and  free  from  all 
noise  and  excitement.  Not  too  many  birds  or  small  animals 
should  be  allowed  in  one  room,  and  the  floors,  roosts,  etc., 
should  be  thoroughly  cleaned  (daily)  and  disinfectants, 
such  as  carbolic  acid  (5  per  cent.)  freely  used.  The  drinking 
water  should  be  kept  fresh,  and  the  food,  when  allowed,  free 
from  dirt,  dust,  and  not  contaminated  with  bowel  discharges. 
Collections  of  feces  on  the  hair  and  feathers  should  be 
removed  daily  with  warm  water  or  bicarbonate  of  soda 
solution  (2  per  cent).  The  mouth  may  be  washed  with  clean 


172  DISEASES  OF   THE  INTESTINES 

water  to  remove  all  food  particles  which  might  remain  to 
decompose  and  eventually  be  swallowed  to  perpetuate  the 
intestinal  disturbance. 

Dietetic.— In  most  cases  of  acute  enteritis,  all  food  is 
withheld  for  at  least  twenty-four  to  forty-eight  hours.  After 
this  time,  when  improvement  begins  to  be  noticeable,  dogs 
may  be  given  small  amounts  of  lean,  meat  finely  divided, 
milk,  beef  tea,  rice  soup,  etc.,  once  or  twice  daily.  Rabbits 
should  be  fed  small  quantities  of  roasted  oats,  corn  or  barley, 
or  roasted  bread.  For  birds  small  amounts  of  cooked  rice, 
oatmeal,  cornmeal  or  bread  and  milk  may  be  given  once 
daily.  Green  foods  should  be  withheld  at  first  and  only 
allowed  in  small  quantities  several  days  after  improvement 
is  noted.  They  tend  to  increase  the  diarrhea  by  their  laxa- 
tive action. 

Medical.— In  mild  cases  of  enteritis,  due  to  errors  in  feeding 
or  irritating  foodstuffs,  etc.,  small  doses  of  laxatives  are 
indicated  to  remove  the  irritating  material  from  the  bowels. 
Castor  oil  (dogs,  15.0-40.0;  cats,  3.0-15.0;  rabbits,  5.0-10.0; 
birds,  1.0-8.0),  or  calomel  (dogs,  0.3-0.4;  cats,  0.1-0.15; 
rabbits,  0.2 ;  birds,  0.05-0.2)  can  be  administered.  Magnesium 
sulphate  (dogs,  10.0-15.0;  cats,  1.0-5.0;  rabbits,  1.0-3.0; 
birds,  1.0-2.0)  is  frequently  used  for  the  same  purpose  owing 
to  its  increasing  the  fluids  in  the  bowels  and  flushing  them 
out  more  promptly  and  thoroughly.  It  is  best  administered 
in  solution  with  warm  water. 

In  more  severe  cases  where  the  diarrhea  is  persistent  after 
the  use  of  laxatives,  it  is  necessary  to  administer  styptics, 
such  as  opium  (dogs,  0.1-0.5;  cats,  0.005-0.2;  rabbits,  0.05- 
0.1;  birds,  0.05-0.1).  In  cases  where  severe  pain  is  present, 
especially  in  dogs,  morphin  sulphate  is  indicated.  It  may  be 
given  (for  dogs,  0.02-0.15)  as  a  subcutaneous  injection  dis- 
solved in  water  (5.00). 

Astringents  are  sometimes  of  value  in  controlling  the 
persistent  diarrhea  and  tannic  acid  is  often  administered 
for  that  purpose  in  the  following  dosage:  Dogs  (0.1-0.5), 
cats  (0.05-0.2),  rabbits  (0.05-0.2),  birds  (0.01-0.05). 

Where  fermentative  processes  continue  in  the  bowels 
disinfectants  may  be  administered:  Lysol  (0.5-2.0),  creolin 
(0.5-2.0),  salol  (0.2-0.8). 


ENTERITIS  173 

It  is  often  advisable  in  dogs  to  wash  out  the  intestinal 
tract  with  bicarbonate  of  soda  solution  (1  to  2  per  cent.) 
followed  by  alum,  tannic  acid  or  iron  sulphate  solutions 
(1  to  2  per  cent.).  This  can  be  done  quite  readily  in  the 
dog  by  the  use  of  a  flexible  rubber  tube  inserted  as  far  up 
into  the  bowels  as  possible.  The  free  end  is  elevated  and  a 
funnel  attached.  The  solution  is  poured  into  the  funnel 
and  allowed  to  gravitate  slowly  into  the  bowels.  When 
there  is  no  obstruction  the  fluid  will  flow  into  the  stomach 
and  be  ejected  through  the  mouth.  In  birds  it  is  best  intro- 
duced with  a  small  syringe,  being  careful  to  avoid  using  too 
much  force.  In  very  severe  cases,  where  general  weakness 
is  apparent,  stimulants  are  advisable.  Subcutaneous  injec- 
tions of  caffein  citrate  (0.1-0.5)  may  be  used  as  a  heart 
stimulant.  Normal  salt  solution,  at  the  body  tempera- 
ture (100°  F.),  is  of  great  value  in  severe  weakness  from 
hemorrhage  or  narcosis.  It  may  be  introduced  intravenously, 
subcutaneously,  intraperitoneally  or  per  rectum. 

Chronic  Enteritis.— Definition.— This  is  a  chronic  inflam- 
mation of  the  small  intestines  involving  the  upper  part  of  the 
large  intestines,  but  often  extending  to  all  parts  of  the  intes- 
tinal mucosa.  Frequently  there  is  extensive  ulceration  at 
different  places  along  the  intestinal  tract.  In  some  cases  the 
stomach  mucosa  is  involved  from  the  same  causes  that  pro- 
duce the  chronic  enteritis. 

Etiology.— Chronic  enteritis  most  commonly  develops 
from  repeated  acute  attacks  or  from  the  same  causes  acting 
mildly  producing  gradually  a  chronic  inflammatory  condi- 
tion. (See  Acute  f^nteritis.) 

Chronic  enteritis  also  occurs  secondary  to  other  diseases, 
such  as  chronic  diseases  of  the  heart,  lungs,  and  liver  which 
cause  interference  with  the  circulation  in  the  walls  of  the 
intestines.  Chronic  infectious  diseases,  such  as  chronic 
distemper,  chronic  constitutional  diseases,  rachitis,  etc., 
have  at  times  chronic  enteritis  associated  with  them.  Para- 
sites in  the  intestinal  tract  are  common  causes. 

Pathology. —The  intestines  always  present  evidences  of 
long-continued  inflammation  of  the  mucosa,  the  surface 
being  covered  with  excessive  secretions  of  mucus  or  muco- 


174  DISEASES  OF  THE  INTESTINES 

purulent  material.  There  are  extensive  areas  of  thickening 
in  the  mucous  membrane;  erosions  and  atrophy  may  too  be 
present.  Ulcerations  and  cicatrices  are  often  noted.  Ulcera- 
tions  may  lead  to  perforation  of  the  bowel  wall  producing 
a  localized  area  of  adhesive  peritonitis,  or  in  some  cases  a 
generalized  peritonitis.  The  mucous  membrane  is  usually 
bluish-red  and  at  various  points  will  be  noted  light  and  dark 
points  due  to  the  pathological  changes  in  the  structure  of 
the  membrane.  The  intestinal  contents  are  usually  liquid, 
of  a  slate  gray  color  and  emit  a  very  offensive  odor.  Some- 
times when  constipation  is  present  the  feces  will  be  dry  and 
hard  in  the  large  bowels,  and  of  a  grayish  color. 

Symptoms.— The  most  conspicuous  symptom  is  a  continu- 
ous or  intermittent  diarrhea.  However,  diarrhea  may  alter- 
nate with  constipation.  The  general  symptoms  are  dulness, 
gradual  emaciation,  rough  hair  coat  and  inanition  which  is 
marked  owing  to  the  lost  or  variable  appetite  and  the  inter- 
ference with  digestion  and  food  assimilation.  From  time 
to  time  the  bowels  are  distended  with  gases  from  the  fer- 
mentative processes  in  the  intestinal  tract.  This  is  especially 
marked  when  constipation  is  present  and  the  peristalsis 
reduced.  At  other  times  large  quantities  of  gases,  feces 
mixed  with  mucus  and  often  streaked  with  blood,  are  passed 
during  the  period  of  diarrhea. 

In  most  cases  there  is  little  evidence  of  abdominal  pain, 
except  when  ulceration  of  the  bowel  wall  takes  place  and  an 
adhesive  or  a  general  peritonitis  is  produced.  Then  all  the 
evidences  of  inflammation  of  serous  membranes  are  present. 
(See  Peritonitis). 

Diagnosis.— The  long-continued  course,  the  intermittent 
diarrhea,  the  anamnesis  and  the  general  condition  of  the 
animal  will  be  sufficient  in  most  cases  to  make  a  compara- 
tively accurate  diagnosis.  However,  a  careful  and  thorough 
examination  should  always  be  made  to  determine  if  possible 
the  cause  of  the  enteritis.  This  is  valuable  especially  for  a 
proper  prognosis  and  rational  therapeutics.  The  feces 
should  be  carefully  examined  for  parasites  and  their  ova,  as 
these  form  a  frequent  cause. 


INTESTINAL  HEMORRHAGE— ENTERORRHAGIA     175 

Further,  as  this  condition  is  often  secondary  to  other 
diseases,  a  differential  diagnosis  should  always  be  attempted. 
Look  for  chronic  constitutional  diseases,  diseases  of  the  liver, 
heart  and  lungs  and  chronic  infectious  diseases.  In  birds 
an  examination  should  be  made  for  infectious  asthenia  and 
parasites. 

Prognosis.— Chronic  enteritis  whether  of  primary  or  sec- 
ondary origin  should  be  considered  unfavorable  owing  to 
the  pathological  changes  which  have  taken  place  in  the 
mucous  membrane.  Complete  recovery  can  hardly  be 
expected  even  in  mild  cases.  In  mature  animals  the  prog- 
nosis is  considered  more  favorable  than  in  young  animals. 
When  it  occurs  secondary  to  other  diseases  the  prognosis 
depends  largely  upon  the  primary  disease. 

Treatment.— A  careful  regulation  of  the  diet  (see  Acute 
Enteritis)  is  of  great  importance  and  should  be  thoroughly 
impressed  upon  the  attendant. 

Medical.—  The  action  of  the  bowels  should  be  kept  as 
regular  as  possible  by  the  use  of  castor  oil,  magnesium 
sulphate,  etc.  (See  Acute  Enteritis.)  When  diarrhea 
becomes  persistent  astringents  are  indicated  as  in  acute 
enteritis. 

Washing  out  the  bowels  (see  Acute  Enteritis)  is  especially 
valuable  in  chronic  enteritis  to  remove  irritating  material, 
mucus,  fecal  matter,  etc. 

If  parasites  are  present  proper  anthelmintics  should  be 
employed.  (See  Parasites  in  the  Intestines.) 

To  encourage  the  appetite  and  to  aid  in  digestion,  bitter 
stomachics  (gentian,  nux  vomica)  are  indicated.  In  the 
treatment  an  attempt  should  always  be  made  to  remove  the 
cause;  when  secondary  to  other  diseases  treatment  should 
be  given  to  promote  the  removal  of  the  fundamental  disease. 


INTESTINAL  HEMORRHAGE.     ENTERORRHAGIA. 

Definition.— This  is  a  condition  where  hemorrhage  takes 
place  from  the  intestinal  mucosa.    It  may  be  due  to  a  definite 


176  DISEASES  OF   THE  INTESTINES 

change  in  the  structure  of  the  mucosa  or  occur  during  the 
course  of  certain  diseases  attended  by  hemorrhagic  diatheses. 

Etiology. — The  causes  of  intestinal  hemorrhage  are  quite 
numerous:  (a)  Mechanical  agents,  such  as  sharp  foreign 
bodies  which  penetrate  the  intestinal  mucosa  and  injure  the 
bloodvessels,  producing  a  more  or  less  severe  hemorrhage. 
Parasites,  by  their  irritating  action  on  the  mucous  membrane, 
or  by  burrowing  into  the  mucosa,  will  produce  the  same 
result.  Injuries,  such  as  being  run  over  by  vehicles,  kicks, 
blows,  etc.,  over  the  region  of  the  abdomen  will  often  rupture 
some  of  the  vessels  in  the  intestinal  mucosa,  resulting  in 
hemorrhage.  Powdered  glass,  when  administered  to  destroy 
animals,  will  produce  severe  hemorrhage  by  the  fragments 
of  glass  penetrating  the  mucosa  and  opening  the  vessels. 

(6)  During  the  course  of  poisonings  by  chemicals  or  caustic 
substances,  severe  hemorrhage  often  takes  place  due  to  the 
corrosive  action  on  the  mucous  membrane.  Drugs,  when 
administered  in  large  doses,  may  produce  a  congestion  of  the 
bloodvessels  of  the  mucosa,  resulting  occasionally  in  over- 
distention  and  rupture. 

(c)  Hemorrhage  takes  place  sometimes  from  an  engorge- 
ment of  the  intestinal  circulation  from  diseases  of  the  heart 
and  liver,  hemorrhagic  infarction  of  the  bowel  from  embolism 
or  thrombosis  of  the  mesenteric  vessels,  intussusception  or 
strangulation  of  the  bowel,  or  hernia.     In  these  cases  the 
hemorrhage  may  result  from  an  overdistention  of  the  blood- 
vessels. 

(d)  During  the  course  of  some  diseases  severe  hemorrhage 
in  the  intestinal  tract  occurs,  as  in  anemias,  severe  infections 
(distemper)  and  certain  degenerations. 

(e)  Tumors  (carcinomas)  and  ulcerations  on  the  mucous 
membranes  may  lead  to  severe  hemorrhage  by  destruction 
of  some  of  the  bloodvessel  walls.    Hemorrhoids,  collections 
of  feces,  etc.,  may  produce  hemorrhage  in  the  large  bowels. 

Symptoms.— Hemorrhage  in  the  intestinal  tract  is  often 
difficult  to  recognize,  unless  the  quantity  of  blood  is  sufficient 
to  distend  the  bowels,  or  be  ejected  through  the  rectum.  In 
mild  cases  of  hemorrhage  only  general  weakness  and  paleness 


INTESTINAL  HEMORRHAGE—ENTERORRHAGIA      177 

of  the  mucous  membranes  may  be  recognized.  When  the 
hemorrhage  has  been  severe  from  the  small  bowels  the  feces 
will  be  very  dark  and  of  a  tarry  consistency;  from  the  large 
bowels  and  rectum  the  color  is  a  bright  red  the  blood  being 
well  preserved.  In  severe  hemorrhage  the  symptoms  are 
those  of  extensive  hemorrhage  from  any  source.  Sudden 
paleness  of  the  membranes,  rapid  weakness,  etc.,  are  the 
most  prominent  symptoms  observed.  Repeated  small  hemor- 
rhages, such  as  occur  during  ulceration,  action  of  parasites, 
etc.,  may  produce  different  grades  of  anemia,  depending  upon 
the  extent  of  the  hemorrhage. 

Diagnosis.— This  can  only  be  made  after  a  careful  examina- 
tion of  the  animal  and  the  discharges  from  the  bowels.  When 
slight  hemorrhages  take  place,  a  microscopic  examination 
of  the  discharges  may  be  necessary  to  determine  the  presence 
of  blood. 

Prognosis.— This  depends  upon  the  cause,  and  the  extent 
of  the  hemorrhage.  In  most  cases  bowel  hemorrhage  should 
be  considered  serious,  as  it  is  often  impossible  to  determine 
the  cause  or  extent  of  the  hemorrhage. 

Treatment.— The  cause  should  be  determined  if  possible, 
as  the  treatment  depends  very  largely  upon  this  factor. 
Opium  is  often  of  great  value  to  suppress  peristalsis.  The 
tincture  may  be  used  in  the  following  dosage:  For  dogs 
(0.5-1.0),  cats  (0.2-0.5),  rabbits  (0.2-0.5),  birds  (0.1-0.2). 
Astringents,  such  as  tannic  acid,  etc.,  are  also  indicated. 
They  should  be  administered  in  rather  large  doses,  and 
repeated  every  hour  or  so.  Adrenalin  chlorid  is  most  useful 
in  severe  hemorrhage:  The  dose  for  dogs  is  2.0  of  a  1-1000 
solution  given  every  hour;  other  animals  one-half  the  quantity. 
Ergot  may  also  be  used.  Hemorrhage  from  the  rectum  or 
large  bowels  is  best  treated  by  injections  of  gelatin  dissolved 
in  hot  water,  astringents  (alum  2-5  per  cent.),  or  cold  water. 
The  injections  should  be  repeated  as  often  as  necessary  to 
control  the  hemorrhage. 

When  there  is  great  loss  of  blood,  normal  salt  solution 
(500.0)    should    be   administered    intraperitoneally  or    per 
rectum.     Further  treatment  depends  upon  the  symptoms 
that  develop. 
12 


178  DISEASES  OF  THE  INTESTINES 

DIARRHEA. 

Definition.— This  term  is  applied  to  a  too  frequent  discharge 
of  more  or  less  fluid  feces.  The  condition  may  vary  greatly 
in  small  animals  from  a  slight  increase  in  the  daily  evacua- 
tions to  repeated  evacuations  of  large  quantities  of  liquid 
feces.  It  is  important  to  note  that  often  repeated  evacuations 
of  small  amounts  of  liquid  feces  may  occur  even  when  an 
actual  obstruction  of  the  bowels '  (fecal  impaction)  exists. 

Etiology.— The  essential  condition  in  diarrhea  is  an  abnor- 
mal increase  of  fluid  in  the  feces.  The  causes,  therefore,  will 
be  found  to  be  those  which  occasion  a  rapid  evacuation  of  the 
bowel  contents,  or  a  reduction  in  the  absorption  from  the 
bowels;  or  an  oversupply  of  fluid  in  the  bowels  either  from 
the  ingestion  of  large  quantities  of  water  or  any  over- 
abundant secretion  from  the  mucous  membrane. 

Normally  the  contents  of  the  small  bowels  are  fluid.  They 
pass  from  the  stomach  to  the  large  bowels  in  a  few  hours. 
The  contents  of  the  large  bowels  become  gradually  hardened 
from  the  absorption  of  the  water  during  their  passage  through 
this  part  of  the  intestinal  tract,  which  requires  in  small 
animals,  from  twelve  to  twenty  hours.  Any  conditions 
therefore  that  hasten  the  movements  of  the  contents  through 
the  large  bowels  would  tend  to  make  the  feces  softer  or  liquid. 
The  same  result  may  occur  from  a  variety  of  conditions  which 
disturb  the  process  of  absorption  and  keep  the  feces  in  a  liquid 
state.  Occasionally  conditions  that  influence  the  absorption 
from  the  mucous  membrane,  such  as  irritations  of  various 
kinds,  at  the  same  time  excite  the  secretion  of  considerable 
quantities  of  fluids.  These  same  agents  may  also  increase 
peristalsis  and  thus  hurry  the  contents  through  the  bowels. 
The  most  common  causes  of  diarrhea  therefore  are:  (a) 
Drinking  excessive  quantities  of  water  or  eating  large  quan- 
tities of  fat  meat,  lard,  or  butter  will  result  in  diarrhea.  The 
unabsorbed  fat  or  its  decomposition  in  the  intestinal  tract 
acts  as  an  irritant  and  greatly  increases  intestinal  activity. 

(6)  Foods  will  sometimes  produce  diarrhea  by  their  irri- 
tating action  on  the  mucous  membrane.  Such  substances 
as  table  scraps  containing  fruit  stones,  parings,  or  fish, 


DIARRHEA  179 

.cheese,  milk,  etc.,  may  undergo  fermentative  changes  in  the 
intestinal  tract  or  from  their  decomposition  contain  preformed 
toxic  substances  which  excite  diarrhea.  Excessive  amounts 
of  food  may  set  up  a  diarrhea  as  a  result  of  derangement  of 
the  gastric  digestion  and  secondary  bacterial  fermentations. 

(c)  A  large  number  of  purgatives,  when  administered  in 
large  doses,  will  produce  diarrhea  by  acting  upon  the  muscle 
of  the  bowel  and  the  nervous  mechanism  stimulating  peri- 
stalsis and  thus  hastening  the  contents  through  the  bowels 
before    absorption    can    take   place.      Salines    (magnesium 
sulphate)  increase  the  amount  of  fluid  in  the  bowels,  and  also 
stimulate  peristalsis.    Some  foods  in  which  bacterial  decom- 
position has  taken  place  will  have  an  action  similar  to  salines 
greatly  increasing  the  amount  of  fluids  in  the  bowels  by  excit- 
ing secretion  from  the  glands  in  the  mucosa. 

(d)  In  some  animals  (cat)  the  nervous  mechanism  of  the 
stomach  will  be  greatly  influenced  by  shock,  fright,  excite- 
ment, etc.,  and  severe  diarrhea  may  result. 

(e)  Diarrhea  may  result  from  diseases  of  other  organs.    In 
diseases  of  the  stomach,  when  undigested  food  is  passed 
into  the  intestines,  the  resulting  irritation  may  induce  severe 
diarrhea.    In  valvular  insufficiencies  or  other  heart  lesions  a 
congestion  of  the  mucous  membrane  of  the  bowel  results  and 
an  excessive  secretion  follows.    Diseases  of  the  kidney  may 
also  produce  diarrhea  by  vicarious  excretion  of  urea  ma 
intestinal    tract.      The    urea    decomposes    producing    free 
ammonia  which  irritates  the  mucosa  causing  a  severe  form 
of  diarrhea. 

(/)  Various  infections  in  the  bowels  (distemper,  etc.)  are 
associated  with  a  more  or  less  intense  diarrhea.  Infections 
with  lesions  at  some  distance  from  the  bowels  may  have 
diarrhea  as  a  consequence  due  to  the  elimination  of  toxic 
substances  from  the  intestinal  mucous  membrane,  which 
can  result  in  severe  diarrhea.  An  overproduction  of  bile 
during  the  course  of  some  diseases  of  the  liver  can  have  the 
same  effect. 

(g)  Organic  diseases  of  the  bowels  (catarrhs,  ulcerations) 
often  lead  to  diarrhea  from  the  irritation  and  resultant 
products  of  decomposition. 


180  DISEASES  OF  THE  INTESTINES 

(K)  The  normal  contents  of  the  bowels  contain  numerous 
varieties  of  organisms,  which  under  abnormal  conditions 
may  multiply  sufficiently  or  increase  in  virulence  as  to 
bee  me  pathogenic,  producing  diarrhea. 

(i)  Various  specific  organisms  (coccidia,  etc.)  produce 
diarrhea.  They  will  be  considered  under  the  diseases  caused 
by  them. 

Symptoms.—  The  clinical  symptoms  of  diarrhea  depend 
largely  upon  the  part  of  the  intestine  affected  and  the  nature 
of  the  causative  agent.  When  due  to  errors  in  feeding  and 
the  upper  part  of  the  intestine  is  involved,  diarrhea  may  not 
occur  if  the  posterior  bowels  remain  normal.  In  diarrhea  the 
discharges  from  the  bowels  consist  of  portions  of  undigested 
food,  mucus,  etc.,  and  are  yellowish  or  greenish  in  color, 
due  in  part  to  unchanged  bile  or  to  pigment  derived  from 
fermentation.  Excessive  acidity,  which  has  not  been  suffi- 
ciently neutralized  in  the  small  intestines,  may  produce 
inflammation  in  the  lower  bowel,  due  to  its  irritant  action 
upon  the  mucous  membrane.  In  cases  where  both 'the  small 
and  the  large  bowels  are  involved  the  discharges  are  more 
abundant  and  liquid.  The  feces  will  be  very  thin  and  of  a 
yellowish  or  a  dark  brown  color.  When  the  large  bowel  is 
particularly  affected,  the  animal  shows  frequent  attempts 
at  defecation,  and  only  a  small  amount  of  feces  and  blood 
mixed  with  quantities  of  mucus  will  be  passed. 

In  the  more  severe  forms  of  diarrhea  colicky  pains  are 
often  observed  and  in  some  cases  the  pain  becomes  intense. 
There  are  frequent  attempts  at  defecation,  and  tenesmus 
is  not  unusual.  When  severe  diarrhea  is  present  it  frequently 
produces  extreme  prostration  and  in  cats  complete  collapse. 
The  extremities  become  cold,  the  mucous  membranes  at 
first  pale,  later  cyanotic  and  every  evidence  of  extreme 
weakness  appears. 

The  temperature  as  a  rule  becomes  subnormal ;  however,  in 
the  very  early  stages  it  is  often  elevated  one  or  two  degrees. 

The  severity  of  the  symptoms  and  the  course  depend  very 
largely  upon  the  causative  agents  producing  the  diarrhea. 
In  mild  cases  it  lasts  only  a  few  hours;  in  the  severe  forms 
several  davs. 


DIARRHEA  181 

Diagnosis. — This  is  established  mainly  by  determining  the 
cause.  The  history  of  the  case  is  of  great  service  in  this 
regard.  A  thorough  examination  of  the  animal  and  feces 
is  necessary  for  a  differential  diagnosis  to  distinguish  this 
condition  from  specific  diseases  of  the  bowels. 

Prognosis. —The  prognosis  is  favorable  in  most  cases  but 
depends  largely  upon  the  cause.  Diarrhea  is  a  symptom  and 
not  a  disease.  Until  the  cause  is  determined  an  accurate 
prognosis  cannot  be  made. 

Treatment.—  Dietetic.— All  food  should  be  withheld  for  at 
least  twenty-four  to  forty-eight  hours,  especially  where  but 
little  weakness  or  prostration  is  apparent.  Should  weakness 
develop  small  amounts  of  milk,  or  milk  and  egg  beaten 
together,  should  be  given  every  four  to  six  hours.  Later 
when  the  symptoms  of  diarrhea  begin  to  disappear  a  little 
lean  meat  may  be  allowed.  Cats  may  have  small  quantities 
of  rice  and  milk,  or  salmon.  Birds  should  be  allowed  only 
small  quantities  of  oatmeal  or  seeds.  Avoid  the  use  of  laxa- 
tive foods,  or  foods  containing  irritating  material  of  any  kind. 

Medical.—  The  first  indication  in  the  treatment  of  diarrhea 
is  the  evacuation  of  the  irritating  material  from  the  intestinal 
tract.  In  a  large  percentage  of  cases  the  spontaneous  evacua- 
tions are  sufficient  to  rid  the  bowels  of  this  material.  How- 
ever, as  a  general  rule,  it  is  advisable  to  assist  nature  by  the 
administration  of  a  laxative  to  ensure  the  prompt  removal 
of  all  irritating  ingesta.  Castor  oil  (dogs,  15.0-40.0;  cats, 
5.0-10.0;  rabbits  and  birds,  1.0-4.0)  is  valuable.  After  thor- 
ough evacuation  of  the  bowels  opiates  are  indicated  to  con- 
trol the  excessive  peristalsis  and  secretions.  Useful  is  tinct- 
ure of  opium  (dogs,  0.5-1.0;  cats,  0.2-0.5;  rabbits,  0.2-0.5; 
birds,  0.1-0.2).  These  doses  can  be  repeated  every  few  hours 
if  necessary. 

Small  doses  of  lime  water  are  of  value  to  neutralize  exces- 
sive acidity  which  is  often  a  common  condition  in  small 
animals. 

Where  severe  pain  is  present,  which  is  rather  common  in 
the  dog,  small  doses  of  morphin  sulphate  (0.05-0.10)  may  be 
given  subcutaneously. 

Where  the  diarrhea  becomes  persistent,  it  should  be  treated 
as  in  acute  or  chronic  enteritis. 


182  DISEASES  OF  THE  INTESTINES 

CONSTIPATION.     OBSTIPATION.     INTESTINAL 
OBSTRUCTION. 

Definition. — An  infrequent  or  difficult  evacuation  of  feces 
which  are  abnormally  dry  or  hard;  or  may  be  retained. 

Etiology. — The  common  causes  of  constipation  in  dogs  are 
lack  of  exercise  and  feeding  dry  food.  Dogs  kept  in  the 
house  or  kennel  often  withhold  the  feces  until  they  become 
hard  and  dry.  Usually  in  old  dogs  the  peristalsis  becomes 
slowed  and  there  is  lack  of  tone  in  the  muscular  wall  with 
some  dilatation  of  the  large  bowel  which  causes  constipation. 
The  passage  through  the  intestine  may  be  blocked  by  fecal 
masses  (coproliths),  foreign  bodies,  calculi,  parasites  or  hair 
balls,  the  latter  being  more  common  in  cats  as  they  lick  off 
and  swallow  loose  hair.  The  lumen  of  the  intestine  may  be 
narrowed  as  a  result  of  chronic  inflammation,  cicatricial 
contraction,  stenosis,  tumors  within  the  wall,  or  hemorrhoids. 
Causative  conditions  external  to  the  bowel  are  hernias, 
fibrous  adhesions  or  tumors.  Other  causes  are  chronic 
inflammation  of  the  liver  with  suppression  of  bile;  chronic 
diseases  of  the  spinal  cord;  enlarged  prostates  in  old  dogs; 
chronic  inflammation  of  the  anal  glands;  agglutination  of  the 
hair  with  feces  at  the  anus  in  long-haired  dogs.  Rabbits 
are  commonly  affected  by  eating  too  much  dry  food.  Hair 
balls  or  masses  of  hair  and  feces  are  often  found  in  these 
animals.  Birds  occasionally  swallow  feathers  which  accumu- 
late in  the  intestines  interfering  with  the  passage  of  the  con- 
tents. The  most  common  causes  are  dry  feed  and  foreign 
bodies. 

Pathology.— The  feces  are  dry,  hard,  usually  of  a  light  gray 
color  and  sometimes  covered  wLh  mucus  or  streaked  with 
blood.  Coproliths  or  calculi  or  impactions  of  large  size  often 
result  in  necrosis  of  the  intestinal  wall  with  perforation  and 
peritonitis. 

Symptoms.— Mild  cases  show  only  difficult  defecation  at 
long  intervals  (two  to  four  days).  The  feces  are  very  dry, 
hard  and  may  be  streaked  with  blood  from  injuries  produced 
in  the  rectal  mucosa. 

In  severe  cases  the  retained  feces  decompose  producing 


CONSTIPATION— OBSTIPATION  183 

toxins  which  are  absorbed  and  intoxicate  the  patient.  The 
animal  will  show  depression,  loss  of  appetite,  increased  tem- 
perature (103°-104°  F.),  and  thirst.  Frequent  efforts  at 
defecation  are  made,  the  attempts  inducing  cries  of  pain. 
There  is  a  characteristic  carriage  of  the  tail  which  is  arched 
as  when  defecating,  and  a  fulness  of  the  abdomen.  Vomiting 
is  not  uncommon  especially  in  the  more  acute  cases,  the 
vomitus  containing  some  bile  and  feces.  Rabbits  often  show 
paralysis  of  the  posterior  parts.  Birds  make  frequent 
attempts  to  pass  feces  and  usually  sit  or  stand  in  an  upright 
position.  By  palpation  large  hard  masses  in  the  posterior 
bowel  can  be  determined. 

Digital  examination  per  rectum  or  over  the  abdomen  will 
often  reveal  sensitiveness  and  the  impacted  fecal  masses. 

Diagnosis.— The  frequent  attempts  to  defecate,  the  condi- 
tion of  the  evacuated  material,  and  the  presence  of  fecal 
masses  on  digital  examination  will  readily  identify  the  con- 
dition. 

Prognosis. — Favorable  in  mild  cases  when  due  to  errors  in 
feeding;  otherwise  depends  entirely  upon  the  causes. 

Treatment.— Mild  cases  of  constipation  may  be  relieved 
by  the  use  of  a  purgative  given  in  full  doses  (castor  oil  I). 
15.0-40.0,  C.  5.0-10.0;  calomel  0.05-0.15),  while  in  chronic- 
cases  after  these  purgative^  clear  the  bowel  small  doses  of 
laxatives  (extract  of  cascara  sagrada,  2.0-10.0;  tincture  rhei, 
5.0-10.0)  must  be  given  for  some  time  to  prevent  a  recur- 
rence of  the  condition.  Tincture  of  mix  vomica  (0.3-0.6)  or 
strychnin  sulphate  (0.001)  is  useful  to  stimulate  peristalsis, 
especially  when  there  is  enervation  from  diseases  of  the  cord, 
and  to  increase  the  tone  of  the  muscular  wall  in  dilatations. 
In  obstinate  cases  large  quantities  of  warm  soapy  water,  or 
oil  and  water,  introduced  with  a  soft  rubber  tube  and  irri- 
gator  well  up  into  the  rectum,  will  stimulate  peristalsis, 
lubricate  and  soften  the  fecal  masses  and  facilitate  removal. 
A  blunt  irrigating  curette  can  be  used  to  break  down  the 
hard  masses.  Manipulation  of  the  abdomen  while  irrigating 
is  often  beneficial. 

Rabbits  may  be  relieved  by  the  use  of  purgatives  (castor  oil, 
2.0-4.0;  tincture  rhei,  0.3-0.6)  and  a  diet  of  green  foods,  vege- 


184  DISEASES  OF   THE  INTESTINES 

tables,  etc.,  should  be  supplied.  Chickens  may  be  treated  with 
enemas  of  glycerin,  or  warm  soapy  water,  and  massaging  over 
the  abdomen.  Fecal  masses,  calculi  or  foreign  bodies  that  can- 
not be  evacuated  by  any  of  the  above  methods  may  be  removed 
by  laparotomy  and  enterotomy.  This  operation  should  be 
performed  early  before  necrosis  occurs  in  which  case  enter- 
ectomy  must  be  resorted  to  and  the  necrotic  portion  of  the 
intestine  resected  (see  Enterectomy) .  The  modus  operandi 
is  as  follows:  Perform  laparotomy  (see  Laparotomy)  at  the 
median  line  just  posterior  to  the  umbilicus  and  withdraw  the 
intestine  containing  the  obstruction.  Ligate  the  bowel  with 
a  heavy  suture  or  tape  on  either  side  of  the  obstruction 
to  prevent  escape  of  contents  and  control  hemorrhage  by 
ligating  all  vessels  supplying  the  part  to  be  operated.  Make 
an  incision  lengthwise  of  the  bowel  opposite  the  blood  supply 
and  of  sufficient  length  to  remove  the  obstruction  which 
must  be  done  carefully.  Cleanse  the  bowel,  and  suture  the 
mucous  membrane,  and  then  the  muscular  coat  with  con- 
tinuous sutures  applied  very  close  to  the  edge  and  then  apply 
continuous  Lembert  sutures  over  these.  By  suturing  the  two 
layers  separately,  there  is  less  tissue  in  the  part  to  be  folded 
on  by  the  Lembert  sutures.  Remove  the  ligatures  from 
around  the  bowel  and  the  vessels,  cleanse  and  return  to  the 
cavity. 

Constipation  due  to  cicatricial  contraction  or  stenosis  may 
be  alleviated  by  entero-enterotomy.  Perform  laparotomy 
as  for  enterotomy,  withdraw  the  part  of  the  intestine  involved 
and  apply  a  long  bowel  clamp  lengthwise  across  a  curved 
portion  of  the  bowel,  clamping  off  about  three  inches  above 
the  affected  area,  and  another  below,  having  not  less  than 
eight  inches  between  the  two  clamps.  Bring  the  clamped- 
off  portions  in  apposition,  making  a  circular  loop  in  the  bowel, 
thus  having  the  peristalsis  in  the  same  direction.  Apply 
continuous  sutures  through  the  muscular  and  serous  coat 
of  the  clamped  off  portion  just  above  the  clamps,  bringing 
the  two  parts  in  contact  and  leave  the  suture.  Make  an 
incision  from  one  to  one  and  a  half  inches  long  of  same  length 
and  position  in  each  bowel.  Apply  continuous  suture  over 
the  free  edges  in  contact.  Loosen  clamps  but  leave  in  posi- 


VOLVULUS  18,5 

tion,  and  continuing  with  the  latter  suture,  apply  Council's 
sutures  closing  the  opening.  Then  beginning  with  the  first 
suture  apply  Lembert  sutures  around  to  the  point  of  begin- 
ning. Remove  vessel  ligatures,  cleanse  and  return  to  the 
abdominal  cavity. 

Following  these  operations  all  food  must  be  withheld 
twenty-four  to  forty-eight  hours  and  then  only  small  amounts 
of  liquid  food  for  several  days.  Tumor  formations  in  the 
bowel  are  rare  but  when  causing  trouble  must  be  removed 
by  enterectomy  (see  Enterectomy) . 


VOLVULUS. 

Definition.— An  intestinal  obstruction  due  to  a  twisting 
or  knotting  of  the  bowel. 

Etiology. — This  condition  is  rare  in  dogs  owing  to  the 
short  mesentery.  It  may  occur  following  falls  or  rough 
handling  by  children  during  play,  or  by  a  portion  of  the 
bowel  passing  through  an  opening  in  the  mesentery  caused 
by  an  injury  or  following  operations  (enterectomy). 

Pathology.— Volvulus  of  the  bowel  is  more  or  less  obstructive 
owing  to  twisting  or  kinking  which  it  produces.  In  other  cases 
a  loop  of  intestine  is  twisted  about  another  like  a  bow  knot 
or  slipped  through  an  opening  in  the  mesentery  which  partly 
obstructs  the  passage  of  the  contents.  Gas  formation  soon 
dilates  the  bowel  further  obstructing  it  and  also  the  blood- 
vessels. When  the  obstruction  is  complete  the  bowel  above 
is  much  distended  while  the  part  actually  involved,  having 
the  circulation  arrested,  will  appear  dark  red  and  later 
become  necrotic  leading  to  peritonitis. 

Symptoms.— As  the  condition  is  acute  the  symptoms  appear 
suddenly  and  are  very  pronounced.  They  are  abdominal 
pain,  accompanied  by  vomiting,  great  prostration  and  a 
hard,  rapid  pulse.  Palpation  of  the  abdomen  may  or  may 
not  produce  much  pain;  sometimes  no  change  in  the  intestine 
can  be  detected. 

Diagnosis.— The  acute  abdominal  pain,  the  sudden  onset, 
rapidly  increasing  severity  of  the  symptoms,  vomiting  and 


186  DISEASES  OF  THE  INTESTINES 

rapid  pulse,  serve  to  identify  volvulus  and  differentiate  it 
from  other  more  chronic  forms  of  intestinal  obstruction. 

Prognosis.— Unfavorable  unless  recognized  early  when  a 
prompt  operation  affords  relief. 

Treatment.— Injections  of  large  quantities  of  warm  water 
or  of  air  into  the  rectum  may  be  beneficial  in  some  cases. 
However,  owing  to  the  rapid  changes  taking  place  in  the  bowel, 
laparotomy  should  be  performed  early,  and  an  attempt 
made  to  reduce  the  volvulus.  Should  the  involved  part  of 
the  intestine  be  necrotic,  enterectomy  must  be  employed  to 
remove  the  entire  part  affected. 

INTUSSUSCEPTION. 

Definition. — The  invagination  of  a  part  of  the  intestine 
into  an  adjacent  portion. 

Etiology . —The  exact  causes  are  not  known,  although  from 
the  conditions  under  which  it  occurs  and  by  experiments 
it  is  believed  to  be  due  to  irregular  innervation  by  which 
a  given  spot  is  contracted  while  immediately  below  it  there 
is  a  dilatation,  thus  permitting  the  latter  to  invaginate  the 
former.  It  may  be  produced  by  supercatharsis,  increased 
production  of  bile  (icterus),  or  the  taking  of  cold  water 
immediately  following  severe  exercise,  all  of  which  excite 
innervation  or  produce  sudden  increase  in  peristalsis.  Pre- 
disposing causes  are  constipation;  dilatations  following 
removal  of  fecal  masses  by  enterotomy;  end-to-end  enterec- 
tomy, the  circular  cicatrix  being  incapable  of  contraction  or 
dilatation  which  favors  invagination;  tumors  in  the  intestinal 
wall.  Intussusception  may  involve  any  part  of  the  small 
intestine.  The  small  intestine  may  pass  in  the  ileocecal 
valve.  Invagination  of  the  colon  or  rectum  may  also  occur. 

Pathology.— Intussusception  is  a  condition  in  which  one 
part  of  the  bowel  slips  into  another  forming  a  sausage-like 
enlargement  of  varied  length.  The  enlargement  is  slightly 
curved  from  tension  of  the  mesentery.  As  a  result  of  the 
constriction,  blood  circulation  is  interfered  with  and  often 
entirely  arrested.  In  the  early  stages  there  is  slight  redden- 
ing, later  the  parts  are  swollen,  congested  and  of  bluish  color. 


INTUSSUSCEPTION  187 

Adhesions  occur  between  the  adjacent  layers  in  a  few  hours 
and  finally  the  parts  become  necrotic  and  may  perforate 
leading  to  peritonitis.  The  rapidity  with  which  these  changes 
occur  depends  upon  the  extent  of  the  intussusception  as  the 
farther  the  invagination  the  greater  the  pressure  on  the 
bloodvessels;  if  the  circulation  be  completely  obstructed, 
necrosis  will  occur  in  a  few  hours. 

Symptoms.  —  Intussusception  manifests  itself  early  by 
abdominal  pain,  the  tension  on  the  mesentery  producing 
the  first  symptoms.  It  has  been  noticed  in  a  few  cases 
that  the  animal  will  lie  on  its  back  in  order  to  ease  the 
pain  from  mesenteric  tension.  Later  symptoms  of  acute 
enteritis  become  prominent,  the  feces  frequently  show  the 
presence  of  blood,  there  is  tenesmus,  colicky  pains  and 
occasionally  vomiting,  and  the  vomitus  may  be  mixed  with 
feces.  Palpation  of  the  abdomen  will  often  reveal  an  elon- 
gated enlargement  of  the  bowel  and  slight  pressure  will 
cause  pain.  Palpation  is  difficult  in  very  fat  animals  or  those 
having  a  very  thick-walled  abdomen. 

Diagnosis. —The  presence  of  the  painful  enlargement  of 
the  bowel,  bloody  stools,  tenesmus  and  the  sudden  occur- 
rence are  the  principal  diagnostic  features. 

Prognosis.  — Unfavorable  in  all  cases  not  operated  early.  If 
recognized  early  and  reduced  or  the  portion  excised  (enter- 
ectomy)  a  good  recovery  may  be  expected.  Spontaneous 
healing  may  occur  by  sloughing  of  the  invaginated  portion 
and  adhesion  at  the  anterior  part. 

Treatment.— Intussusception  of  the  posterior  part  of  the 
bowel  may  be  reduced  in  the  early  stages  by  dilating  the 
bowel  with  rectal  injections  of  large  quantities  of  warm 
water,  using  as  much  pressure  as  can  be  applied  safely.  Air 
may  also  be  used  in  the  same  manner.  Purgatives  or  specific 
stimulants  to  peristalsis  should  not  be  used  as  they  only 
serve  to  increase  the  invagination.  Operative  measures 
should  be  at  once  resorted  to  when  other  efforts  fail.  A 
laparotomy  should  be  performed  at  the  median  line  just 
posterior  to  the  umbilical  scar,  the  enlarged  portion  of  the 
bowel  sought  and  attempts  made  to  reduce  it  by  careful 
manipulation.  A  small  blunt  probe  or  scalpel  handle  may 


188  DISEASES  OF  THE  INTESTINES 

be  inserted  between  the  adhered  peritoneal  surfaces  to  break 
down  the  adhesions  which  hold  the  two  layers  together.  If 
this  is  impossible  enterectomy  must  be  performed.  Place 
ligatures  of  heavy  suture  material  around  the  bowel  a  short 
distance  above  and  below  the  affected  area  and  cut  off  the 
bowel  with  scissors  making  the  incision  diagonally  across  the 
intestine.  Cut  off  the  mesentery  supporting  the  part  to  be 
removed,  ligating  each  vessel  as  it  is  reached.  Bring  the 
parts  of  the  bowel  in  end-to-end  contact  and  suture  with 
Council's  sutures  or  if  preferred  a  lateral  anastomosis  may 
be  used.  After-treatment  is  the  same  as  for  enterotomy. 


WOUNDS  OF  THE  INTESTINES. 

Definition.— Wounds  of  the  intestines  frequently  occur  in 
small  animals,  especially  the  dog,  which  is  more  subject  to 
injury  than  the  cat,  rabbit  or  bird. 

Etiology.— The  most  common  causes  are:  Falling  from  a 
great  height,  being  run  over  by  vehicles,  kicks,  or  severe 
blows  over  the  abdomen.  Punctured  wounds  of  the  abdomen 
often  penetrate  the  intestines,  such  as  gunshot  wounds  or 
those  produced  by  sharp  objects  (forks,  etc.)  which  penetrate 
the  abdominal  walls.  Penetrating  wounds  should  always  be 
considered  serious,  as  the  extent  of  the  injury  in  the  abdom- 
inal cavity  is  difficult  to  determine.  There  is  also  danger  of 
infection  being  carried  into  the  abdominal  cavity  from  with- 
out, or  from  within,  the  bowel  contents  escaping  into  the 
cavity  and  causing  septic  peritonitis. 

Symptoms.— Injuries  to  the  intestines  are  often  difficult 
to  recognize,  especially  those  produced  by  kicks,  blowrs  and 
other  forms  of  external  violence.  The  most  prominent  symp- 
toms of  intestinal  wounds  are  hemorrhage  and  collapse. 
Often  the  abdomen  will  become  distended  with  blood  when 
the  bowel  is  ruptured.  The  anamnesis,  paleness  of  the 
mucous  membranes  and  the  sudden  enlargement  and  dis- 
tention  of  the  abdomen  usually  suffice  for  diagnosis.  However, 
an  accurate  diagnosis  cannot  be  made,  unless  an  explorative 


WOUNDS  OF   THE  INTESTINES  189 

laparotomy  is  performed,  and  the  cavity  most  thoroughly 
inspected.  Other  organs  in  the  abdominal  cavity  may  also  be 
injured  by  the  causes  mentioned.  The  symptoms  produced  by 
punctured  wounds  depend  very  largely  upon  the  extent  of  in- 
jury to  the  intestines  or  other  organs.  Gunshot  wounds  when 
of  small  caliber  will  not  produce  any  very  marked  symptoms 
other  than  tenderness  over  the  abdomen.  Healing  may  follow 
readily.  Small  wounds  may  not  penetrate  farther  than  the 
mucosa  which  may  pouch  outward  through  the  opening  and 
prevent  the  escape  of  the  intestinal  contents.  Later  adhesions 
take  place  preventing  septic  peritonitis.  Larger  wounds, 
however,  usually  prove  fatal  under  symptoms  of  collapse 
from  hemorrhage  or  septic  peritonitis,  unless  an  accurate 
diagnosis  is  made  and  the  proper  treatment  immediately 
applied.  When  punctured  wounds  are  observed,  the  animal's 
general  condition  should  be  noted  at  once.  Avoid  the  use  of 
probes  owing  to  the  danger  of  carrying  infection  into  the 
cavity. 

Treatment.— The  first  indication  in  the  treatment  of  intes- 
tinal wounds  is  to  perform  laparotomy  (see  Laparotomy) 
as  early  as  possible.  A  generous  incision  should  be  made  in 
the  median  line  to  allow  a  complete  and  thorough  examina- 
tion of  the  entire  intestinal  tract  and  other  organs.  The 
intestine  should  be  thoroughly  examined  the  entire  length, 
and  any  wounds  found  closed  with  Lembert  sutures.  If  the 
wound  is  extensive,  as  a  rupture  of  the  bowel,  it  should  be 
closed  as  in  enterotomy.  In  some  cases  where  the  bowel 
wall  becomes  torn  or  has  an  uneven  surface,  a  portion  should 
be  removed.  (See  Enterectomy.) 

The  organs  should  also  be  inspected  and  any  wounds  in 
them  sutured. 

The  abdominal  cavity  should  be  thoroughly  irrigated  with 
a  boric  acid  solution  (2  per  cent.),  or  normal  salt  solution, 
especially  in  those  cases  where  intestinal  contents  have 
escaped  or  blood  is  present. 

Should  the  animal  be  weak  from  loss  of  blood,  stimulants 
should  be  given,  such  as  strychnin  sulphate  (0.001)  repeated 
as  often  as  necessary. 


190  DISEASES  OF   THE  INTESTINES 

CROUPOUS  ENTERITIS  OF  CATS. 

Membranous  Enteritis. 

Definition.— A  croupous  or  membranous  inflammation 
involving  the  mucous  membrane  of  the  intestines. 

Etiology.— Croupous  enteritis  is  observed  most  frequently 
in  kittens  occurring  as  an  epizootic  in  certain  districts  during 
the  winter  and  spring  seasons  of  the  year.  The  exact  etio- 
logical  factor  has  never  been  determined.  It  is  possibly  due 
to  a  virulent  form  of  the  colon  bacillus  aided  by  a  reduction 
in  resistance  from  exposure  to  cold,  irregularities  in  diet, 
parasites,  etc.  Older  animals  are  also  occasionally  affected 
but  not  in  such  large  numbers. 

Pathology.— The  principal  pathological  changes  are  noticed 
on  the  mucous  membrane  of  the  bowels,  the  muscular  walls, 
and  the  mesenteric  lymph  glands.  The  mucous  membrane 
is  highly  congested,  reddened,  swollen,  and  the  surface 
covered  with  a  thick  membranous  exudate.  Often  the  epi- 
thelial surface  and  even  the  submucosa  will  become  loosened 
from  the  other  tissues.  The  wall  of  the  bowel  is  edematous, 
and  the  serous  covering  shows  inflammation.  The  mesen- 
teric lymph  glands  are  enlarged,  edematous,  and  show  acute 
inflammatory  changes.  The  liver,  spleen  and  kidneys  show 
similar  changes.  The  contents  of  the  bowels  are  liquid,  and 
contain  considerable  blood. 

Symptoms.— The  early  symptoms  are:  Vomiting  and  a 
severe  diarrhea  which  come  on  suddenly  and  usually  affect 
several  animals  at  the  same  time.  There  is  a  complete  loss  of 
appetite,  depression,  and  in  twenty-four  to  forty-eight  hours 
the  animals  will  become  very  weak,  comatose  and  die  from 
exhaustion. 

Diagnosis.— The  epizootic  character  of  the  disease,  the  sud- 
den onset  and  the  age  of  the  animal  affected  are  indicative. 
It  can  be  easily  mistaken  for  various  kinds  of  poisonings;  the 
anamnesis  therefore  should  be  carefully  ascertained  to  assist 
in  the  differential  diagnosis. 

Prognosis.  — Should  be  considered  unfavorable;  the  largest 
percentage  of  cases  terminate  fatally. 


INFECTIOUS  ASTHENIA  .OF  BIRDS  191 

Treatment.— Treatment  of  croupous  enteritis  is  as  a  rule 
unsatisfactory.  Little  can  be  done  except  the  administration 
of  general  stimulants  and  bowel  disinfectants.  As  prophy- 
lactic measures,  all  feeding  pans  should  be  thoroughly  cleaned 
and  sterilized,  and  the  discharges  of  the  bowels  carefully 
taken  care  of  to  prevent  further  contamination  of  the  food. 


INFECTIOUS  ASTHENIA  OF  BIRDS. 

Definition.— This  is  a  chronic  disease  found  in  birds,  which 
affects  primarily  the  duodenum  in  the  form  of  a  chronic 
catarrhal  inflammation. 

Etiology.— The  cause  is  a  microorganism  known  as  the 
Bacterium  asthenia?.  It  develops  principally  in  the  duo- 
denum, producing  an  irritation  to  the  mucous  membrane, 
which  gradually  leads  to  chronic  inflammation. 

Pathology. — The  characteristic  lesions  are:  Extreme  ema- 
ciation of  the  muscular  system  with  an  almost  complete 
absence  of  fat.  The  bowels  are  empty,  containing  only  a 
small  quantity  of  slimy  mucus.  The  walls  of  the  duodenum 
are  reddened,  thickened,  and  show  all  the  evidences  of  a 
catarrhal  inflammation  of  the  mucous  membrane.  The 
duodenal  feces  will  contain  large  numbers  of  the  Bacterium 
asthenia1. 

Symptoms.— Infectious  asthenia  is  observed  most  com- 
monly in  young  birds  one  to  six  months  old.  It  is  charac- 
terized by  extreme  emaciation,  variable  appetite,  paleness  of 
the  comb,  wattles  and  membranes.  The  course  is  chronic 
and  the  termination  usually  fatal  in  about  three  months. 
The  extreme  emaciation  which  comes  on  gradually  has  led 
to  the  term  "going  light"  being  given  it.  During  the 
course  of  the  disease  the  birds  become  weak,  anemic,  the 
plumage  rough;  there  is  general  depression  which  causes 
them  to  sit  in  one  position  for  a  long  time.  Death  occurs 
from  cachexia. 

Diagnosis.— The  large  number  of  birds  affected,  the  age  of 
the  birds,  the  long  chronic  course,  and  the  characteristic 
lesions  found  on  postmortem  are  usually  sufficient  to  estab- 


192  DISEASES  OF  THE  INTESTINES 

lish  the  diagnosis.  The  finding  of  the  Bacterium  asthenise 
in  several  of  the  birds  will  confirm  the  diagnosis. 

Prognosis.— Owing  to  the  infectious  nature  of  the  disease, 
the  chronic  course,  and  the  pathological  changes  which  have 
taken  place  in  the  duodenal  mucosa,  the  prognosis  is  unfavor- 
able. Where  the  disease  has  reached  an  advanced  stage  it  is 
advisable  to  destroy  the  bird  and  thoroughly  disinfect  the 
premises. 

Treatment.— Medical.— Small  doses  of  laxative,  castor  oil 
(1.0-4.0)  or  calomel  (0.01-43.05)  should  be  given. 

As  a  stomachic  and  tonic  iron  sulphate  may  be  given  in 
the  drinking  water  (1-1000). 

The  aromatic  seeds  (fennel,  coriander,  anise)  may  be  used 
once  or  twice  daily  with  the  food  to  stimulate  the  secretions 
of  the  stomach  and  intestines. 

Prevention.— The  healthy  birds  should  be  separated  from 
the  sick  ones  at  once.  All  parts  of  the  houses  (roosts,  floors, 
etc.)  should  be  thoroughly  cleaned  and  disinfected  with  a 
carbolic  acid  solution  (5  per  cent.). 


CHAPTER  X. 
PARASITES  IN  THE  INTESTINES. 

HELMINTHIASIS. 

In  small  animals  parasites  in  the  digestive  tract  are  very 
numerous.  They  pass  rapidly  through  the  anterior  portion 
of  the  digestive  tract,  which  prevents  their  becoming  fixed; 
also  in  this  portion  of  the  canal  secretions  for  their  proper 
development  are  lacking.  In  the  stomach,  owing  to  its 
acidity,  they  do  not  remain  long,  but  are  either  destroyed 
or  pass  into  the  small  intestines.  In  a  few  instances,  how- 
ever, they  may  burrow  underneath  the  mucosa  of  the  stom- 
ach. The  intestines  are  favorable  for  the  development  of 
parasites,  owing  to  their  length,  the  presence  of  an  abun- 
dance of  fluid,  and  the  slow  peristaltic  movement  of  the 
bowels  which  does  not  materially  interfere  with  their  fixation 
and  development.  The  majority  of  the  parasites  are  found 
in  the  small  intestines;  fewer  are  found  in  the  cecum,  colon 
and  rectum.  Each  species  of  parasite  has  its  particular 
location,  and  unless  in  unusual  numbers,  or  under  abnormal 
conditions,  they  will  be  found  infesting  an  exclusive  portion 
of  the  bowel.  Parasites  are  frequently  found  in  very  large 
numbers,  and  produce  serious  disturbances  in  the  intestinal 
tract,  depending  upon  the  species  of  parasite  and  the  animal 
infested.  The  most  common  parasites  found  in  the  intestinal 
tract  belong  to  the  animal  kingdom,  and  are:  Cestoda; 
Nematoda;  Acanthocephala;  Coccidia. 

TJENIASIS. 

Cestoda. 

The  dog  is  the  favorite  host  of  the  tirnitv.    They  occur  in 
this  animal  in  considerable  numbers,  sometimes  so  as  to 
13 


194  PARASITES  IN  THE  INTESTINES 

excite  wonder  at  the  continued  good  health  of  the  host. 
More  than  50  per  cent,  of  the  dogs  examined  harbor  worm 
parasites. 

It  is  essential  for  the  taenise  to  have  an  intermediate  host 
to  complete  their  life  cycle.  The  following  animals  serve 
as  intermediate  hosts  for  most  of  them:  Sheep,  ox,  pig, 
horse,  goat,  rabbit,  and  even  man. 

The  head  (scolex)  of  a  tsenia  is  generally  expanded  and 
supplied  with  suckers ;  some  species  in  addition  are  provided 
with  hooks.  From  this  head,  by  proliferation,  is  formed  the 
neck,  a  thin  non-annulated  constriction,  which,  continuing 
and  becoming  wider  produces  the  body  or  strobila.  The 
body  is  in  the  form  of  a  long,  narrow  band  divided  into  more 
or  less  distinct  segments,  and  as  these  become  mature  they 
are  cast  off  gradually  from  the  distal  end  of  the  parasite  as 
new  segments  develop  from  the  head.  Each  of  the  segments 
contain  numerous  eggs  (ova)  which  pass  out  with  the  feces. 
Before  becoming  detached  the  segments  can  also  liberate  ova 
through  an  opening  on  the  lateral  wall  or  ventral  surface, 
called  the  genital  pore,  forming  two  ways  of  disseminating 
the  ova.  When  deposited  in  a  suitable  medium,  preferably 
warm,  moist  soil,  or  filth,  the  ova  undergo  a  series  of  compli- 
cated changes  which  finally  result  in  the  first  larval  form.  In 
this  form  they  are  ingested  by  the  intermediate  host,  most 
commonly  with  the  food  or  water.  They  burrow  through  the 
intestinal  walls  and  migrate  into  the  adjacent  tissues,  or  writh 
the  blood  stream  are  carried  to  remote  parts  where  they 
develop  into  cysts.  During  the  development  of  the  cyst  in 
the  various  organs  serious  conditions,  such  as  "  gid"  in  sheep, 
echinococcus  disease  of  man,  etc.,  may  arise  in  the  new  host. 
As  the  dog  is  the  harborer  of  the  parent  tsenia,  treatment 
should  be  given  not  only  to  reduce  the  disorders  they  occasion 
in  other  hosts  but  also  to  lessen  the  injury  they  produce  in  the 
dog.  The  cyst  form  is  the  limit  of  development  in  the  inter- 
mediate host.  The  life  cycle  can  be  completed  only  in  case 
the  cyst  is  ingested  by  and  reaches  the  digestive  tract  of 
another  host  in  which  it  can  develop.  Dogs  harboring  the 
adult  tsenia  cannot  become  reinfested  by  ingesting  the  larval 
form,  but  the  larval  form  may  migrate  from  the  intestines 


TMNIAS1S  195 

into  adjacent  tissues  and  there  develop  new  cysts.  This  is 
the  limit  of  their  growth,  however,  in  the  host  of  the  adult 
worm. 

Taenias  in  Dogs.— The  most  common  tsenise  found  in  the 
dog  are  as  follows:  (a)  Dipylidium  caninum  (Tcenia  cucum- 
erina),  a  worm  30  to  40  cm.  and  3  mm.  at  its  greatest 
breadth.  Its  club-shaped  head  is  provided  with  four 
suckers  and  four  rows  of  very  small  hooks.  The  neck  is 
long  and  narrow.  The  first  segments  are  narrow,  the  others 
are  longer  than  they  are  wide  and  like  melon  seeds  in  form 
(cucumis).  Genital  pore  double  and  opening  toward  the 
middle  of  each  side  of  the  segments  on  a  slight  prominence. 
Ova  are  globular,  from  37  to  46  microns  in  diameter,  and 
pass  from  the  segments  massed  in  a  small  group  enclosed  by 
a  capsule  (cocoon) .  The  cyst  form  is  the  Cryptocystis  tricho- 
dectis  and  the  intermediate  hosts  are  the  dog  flea  (Cteno- 
cephalus  canis),  dog  louse  (Trichodectis  canis)  and  the  flea 
that  lives  on  man  (Pulex  irritans).  These  intermediate  hosts 
become  infested  by  ingesting  the  ova  of  the  tsenise  which  are 
always  present  on  the  skin  or  hair  of  the  dog  by  having  fecal 
discharge  mixed  with  the  bedding  in  the  kennel.  The  cysts 
develop  usually  in  the  abdominal  cavity  of  the  intermediate 
hosts  which  are  in  turn  swallowed  by  the  dog  with  water  and 
food,  or  while  licking  or  biting  the  skin  to  relieve  the  irrita- 
tion which  they  produce.  They  then  attach  themselves  to 
the  walls  of  the  intestine  where  they  develop  into  the  adult 
worm. 

(b)  Tcenia  pisiformis  (Tcenia  serrata). — This  parasite  is 
about  1  meter  long,  head  a  little  broader  than  the  neck,  and 
armed  with  24  to  38  hooks.  Segments  at  first  are  much 
shorter  than  broad,  about  square  in  the  middle  portion  while 
the  mature  segments  are  10  to  17  mm.  long  by  4  to  t>  mm. 
broad.  Genital  pore  on  the  lateral  border,  and  very  promi- 
nent, causing  the  border  to  appear  convex  and  the  segment 
to  be  wider  in  the  middle  than  at  the  ends.  Posterior  borders 
straight  and  the  angles  uneven  which  gives  the  strobila  a 
saw-like  appearance.  Eggs  are  ovoid  and  30  to  40  microns 
long  and  31  to  30  microns  broad.  The  cyst  form  is  the  Cys- 
ticercus  pisiformis  and  is  frequent  in  the  peritoneal  cavity 


196       PARASITES  IN  THE  INTESTINES 

of  hares  and  rabbits.  Dogs  become  infested  by  eating  the 
viscera  and  in  twelve  days  the  tsenise  are  2  to  3  cm.  long,  and 
matured  in  two  months.  The  ripe  ova  given  to  rabbits 
become  cysticerci. 

(c)  Tcenia  hydatigena   (Tcenia   marginata) .—  This  is  the 
largest  tsenia  found  in  the  dog,  being  1.5  to  2.0  m.  long. 
The  head  is  scarcely  wider  than  the  neck  and  has  30  to  44 
hooks.    The  segments  are  nearly  square  with  the  genital  pore 
on  the  lateral  border  which  begins  to  develop  in  the  seg- 
ments about  one-fourth  of  the  distance  from  the  head.    The 
posterior   border   of   the   segments   is   slightly  wavy,   and 
received  into  the  succeeding  segment.     Mature  segments 
when  detached  are  about  15  mm.  long  by  7  mm.  wide.    The 
ova  are  almost  spherical  and  from  30  to  36  microns  in 
diameter.    The  cyst  form  is  the  Cysticercus  tenuicollis  and 
is  commonly  found  in  the  peritoneum,  pleura  and  even  in  the 
pericardium  of  domesticated  animals,  especially  ruminants. 
It  requires  four  to  five  months  to  fully  develop  into  the  mature 
worm. 

(d)  Multiceps  multiceps    (Tcenia   ccenurus).—  This  worm 
rarely  exceeds  1  m.  in  length.     Head  small,  slightly  broader 
than  the  neck  and  armed  with  22  to  32  hooks.    Segments 
narrower  than  any  of  the  preceding  species,  becoming  square 
with  the  genital  pore  developed  about  the  125th  segment,  15 
to  20  cm.  from  the  head.    Mature  segments  10  to  12  m. 
long,  3  to  4  m.  wide.     Eggs  spherical  31  to  36  microns  in 
diameter.      The  cystic  form   is    the    Multiceps    multiceps 
(Coenurus  cerebralis)   which  is  developed    in  the  cerebro- 
spinal  cavity  of  sheep;  more  rarely  in  other  domesticated 
animals,  causing  the  disease  commonly  called  "gid."    The 
cyst  is  polycephalic,  the  ingestion  of  one  cyst  producing 
numerous  taenise.    The  tsenia  requires  about  two  to  three 
months  to  reach  maturity. 

(e)  Multiceps  serialis  (Tcenia  serialis}.—  This  parasite  is 
45  to  75  cm.  long,  head  wider  than  the  neck  and  having 
26  to  32  hooks.    Segments  similar  to  those  of  the  M.  multi- 
ceps.   The  ripe  segments  are  10  to  16  mm.  long  and  3  to  4 
mm.  wide,  the  posterior  border  being  straight.    Eggs  ovoid 
and  34  microns  long  and  27  microns  wide.    The  cyst  form  is 


TMNIASIS  197 

the  Multiceps  serialis  and  its  intermediate  hosts  are  some 
of  the  rodents  and  warren  rabbits.  This  tsenia  develops 
more  rapidly  than  the  others  requiring  but  a  few  weeks. 

(/)  Echinococcus  granulosiis  (Tcenia  echinococcus).—  This 
species  is  distinguished  from  all  others  by  its  size.  It  is  only 
4  to  5  mm.  long,  and  composed  of  3  to  4  segments,  the  last 
of  which  contains  the  mature  ova.  The  head  is  armed  with 
a  double  row  of  28  to  50  hooks.  Eggs  ovoid,  34  by  25 
microns.  The  cyst  form  is  the  Echinococcus  granulosus 
(E.  polymorphus)  and  is  found  in  most  of  the  organs  of  the 
herbivora  and  even  man,  but  is  more  common  in  the  liver 
and  lungs  of  ruminants  and  pigs.  It  requires  one  month  to 
fully  develop.  This  cyst  is  polycephalic  and  polysomatic. 

Tseniae  in  the  Intestine  of  the  Cat.— Three  species  of 
taenise  have  been  found  in  the  cat. 

(a)  Tcenia  tceniceformis  (Tcenia  crassicollis^.—This  is  the 
most  common  tsenia  found  in  the  cat.  It  attains  a  length 
of  15  to  50  cm.  and  in  appearance  is  similar  to  those  found 
in  the  dog.  The  head  is  armed  with  a  double  crown  of  26 
to  52  hooks  and  is  about  as  wide  as  the  neck.  The  posterior 
segments  are  8  to  10  mm.  long  and  5  to  6  mm.  wide.  Ova  are 
globular  and  31  to  37  mm.  in  diameter.  This  tsenia  is  repre- 
sented in  the  vesicular  or  bladder  form  by  the  Cysticercus 
fasciolaris  which  inhabits  the  liver  of  rats,  mice  and  other 
rodents.  This  cysticercus,  which  is  always  coiled  up  in  a 
cyst  it  has  itself  produced,  is  elongated  in  form,  the  body 
composed  of  segments,  and  from  3  to  20  cm.  long,  while  the 
vesicle  is  ovoid  and  frequently  no  larger  than  a  pea. 

(6)  Tcenia  elliptica  and  (c)  Tcenia  pseudo-elliptica  have 
been  described  as  a  variety  of  the  Dipylidium  caninum  of 
dogs;  they  are  unimportant. 

(d)  The  Bothriocephalus  felis  has  also  been  mentioned. 
Little  is  known  about  it  and  no  disturbance  in  the  cat  has 
been  ascribed  to  its  presence. 

TaeniaB  in  the  Intestine  of  Rabbits.— Cestodes  are  rare  in 
these  animals  and  all  belong  to  one  species,  the  Cittotenia 
denticulata  (Moniezia  denticulata).  These  may  attain  the 
length  of  8  cm.,  head  small  and  supplied  with  suckers.  Seg- 
ments 1  cm.  broad  and  not  so  long.  Two  genital  pores  are 


198       PARASITES  IN  THE  INTESTINES 

in  the  posterior  part  of  the  segment.  The  cyst  form  and 
intermediate  hosts  are  unknown. 

T sendee  in  the  Intestines  of  Birds.— In  the  intestines  of  the 
fowl,  nine  species  of  cestodes  have  been  found— eight  tsenia 
and  one  bothriocephalus.  The  tsenise  are  difficult  to  distin- 
guish from  one  another,  and  as  they  are  rare,  little  work  has 
been  done  to  establish  their  complete  history.  Outbreaks  do 
occur,  however,  in  which  so  many  fowls  are  infested  as  to 
amount  to  an  epizootic  tseniasis. 

(a)  Choanotcenia  infundibuliformis,  length  20  to  130  mm., 
armed  and  supplied  with  suckers.  Intermediate  host  said  to 
be  the  common  house  fly. 

(6)  Dicranotcenia  sphenoides,  length  2  mm.,  head  armed 
and  supplied  writh  suckers.  Intermediate  host  the  earth- 
worm. 

(c)  Davainea  proglottina,  length  1.0-1.5  mm.,  head  armed, 
and  supplied  with  suckers.    The  segments  of  this  taenia  are 
cast  off  as  soon  as  mature.   They  continue  to  live  and  develop, 
greatly  increasing  in  length.    Intermediate  hosts  are  various 
species  of  mollusca. 

(d)  Davainea  cesticillus,  length  9  to  45  mm.,  head  unarmed. 
Intermediate  host  unknown. 

(e)  Davainea  echinobothrida,  length  50  to  100  mm.,  head 
has  suckers  and  is  armed.    Intermediate  host  unknown. 

(/)  Davainea  tetragona,  length  25-100  mm.,  head  has 
suckers  and  armed.  Intermediate  host  unknown.  Very  little 
is  known  of  the  other  species. 

(</)  Tcenia  cantaniani,  the  only  tsenia  found  in  turkeys. 
It  is  14  mm.  long,  head  unarmed,  but  provided  with  suckers, 
and  has  no  neck.  Life  history  unknown. 

(h)  Davainea  crassula  very  rarely  infests  pigeons.  Length 
30  to  40  cm.,  breadth  4  mm.,  head  armed  with  double  crown 
of  60  hooks.  First  segment  short,  posterior  ones  long,  genital 
pores  unilateral.  Ova  very  large,  ovoid,  28  microns  long, 
and  arranged  in  groups. 

Pathology.— TflenicT  are  extremely  frequent  in  dogs,  but  the 
various  species  are  not  equally  distributed,  and  the  variation 
seems  to  pertain  to  different  countries  and  also  to  the  differ- 
ent sections  of  the  country.  The  frequency  of  tsenia  is  also 


T&NIASlft  199 

directly  related  to  that  of  the  cystic  or  bladder  worms 
infesting  ruminants,  rabbits,  and  other  intermediate  hosts. 
The  number  of  individuals  by  which  each  of  these  teenia3 
may  be  represented  in  the  same  dog  is  also  variable.  The 
Dipylidium  caninum  varies  up  to  360,  the  T.  pisiformis  as 
high  as  64,  the  T.  hydatigena  and  the  M.  rnulticeps  usually 
less  than  10,  but  the  Echinococcus  granulosus  from  one  to 
several  thousand.  This  variation  is  due  in  part  to  the  fact 
that  some  cyst  forms  give  rise  to  but  one  adult  parasite 
(monocephalic),  while  others  produce  many  (polycephalic). 
The  common  location  of  the  tsenia  is  in  the  small  intestine; 
only  occasionally  does  it  migrate  to  other  parts  of  the  diges- 
tive canal.  The  head  is  attached  to  the  mucosa  by  suckers  or 
hooks,  and  as  the  body  may  be  folded  on  itself  many  times 
long  parasites  may  only  occupy  a  short  distance  of  the  bowel. 
Large  numbers  are  often  massed  together  almost  completely 
occluding  the  lumen  of  the  bowel.  The  mucosa  is  hyperemic, 
thickened  and  covered  with  mucus.  Some  of  the  glands  are 
hypertrophied.  Rare  cases  of  perforation  of  the  walls  by 
tsenise  have  been  reported,  but  as  a  rule  the  pathological 
changes  are  those  of  a  chronic  enteritis. 

Symptoms.—  Notwithstanding  their  extreme  frequency,  the 
tsenise  often  have  no  apparent  influence  on  the  health  of  the 
dog.  Sometimes,  however,  by  their  accumulation  and  intes-j 
tinal  obstruction,  they  cause  abdominal  pain  or  a  chronic 
enteritis.  The  appetite  is  often  irregular,  but  while  the 
patient  may  eat  well  its  condition  remains  bad.  Growth  is 
checked,  emaciation  often  develops,  and  the  hair  coat  loses 
its  normal  luster.  Young  dogs  are  uneasy,  change  their 
position  frequently  and  show  a  desire  to  bite  the  skin  over 
the  abdomen.  They  may  have  epileptiform  attacks.which 
are  periodical,  with  normal  intervals  between.  When  fre- 
quent, these  attacks  may  be  followed  by  a  gradual  sinking 
and  death. 

The  Tsenia  tseniseformis  of  cats  is  frequently  found  in  large 
numbers  in  the  small  intestines  and  occasions  serious  dis- 
ease. The  appetite  gradually  declines.  A  slight  diarrhea  is  an 
early  symptom  followed  by  constipation;  salivation  is  abun- 
dant; great  prostration;  nervous  phenomena  as  loss  of  sight 


200       PARASITES  IN  THE  INTESTINES 

and  hearing,  and  epileptiform  convulsions  which  occur  at 
intervals. 

Rabbits  exhibit  symptoms  similar  to  the  cat,  except  the 
former  usually  have  a  partial  posterior  paralysis  instead  of 
convulsions. 

Chickens  lose  their  appetite,  become  emaciated,  are  dull 
and  feeble  and  a  few  show  diarrhea.  The  presence  of  seg- 
ments on  the  surface  of  the  feces  is  often  the  only  symptom 
of  tseniasis. 

Diagnosis.— The  poor  or  emaciated  condition  of  the  animal, 
diarrhea  or  constipation,  would  indicate  the  presence  of 
intestinal  parasites,  but  an  accurate  diagnosis  of  tseniasis 
can  only  be  made  by  finding  the  segments  or  ova  mixed  with 
the  feces.  The  ova  can  only  be  detected  by  the  microscope. 
A  microscopic  examination  is  readily  made  by  shaking  some 
of  the  feces  in  a  test-tube,  one-half  full  of  water,  until  the 
mass  is  broken  up.  Allow  it  to  stand  for  a  few  minutes,  and 
with  a  pipette  withdraw  a  quantity  from  the  center  of  the 
fluid.  Place  a  few  drops  on  a  slide,  cover  with  a  cover-glass, 
and  examine  first  with  low,  then  with  high  power.  The 
ova  of  the  tseniadse  all  appear  about  the  same  size.  While 
the  variations  peculiar  to  each  species  make  differentiation 
possible,  it  is  unnecessary  to  consider  them  as  the  prognosis 
and  treatment  are  similar  for  all  the  species.  For  an  accurate 
diagnosis  of  the  species,  the  entire  parasite,  especially  the 
head,  must  be  obtained  and  examined  microscopically. 

Should  the  feces  be  soft  or  liquid,  smear  slides  can  be  made 
and  examined  with  as  good  results.  A  negative  opinion 
should  not  be  given  without  examining  several  slides. 
Usually,  however,  one  finds  20  or  30  ova  on  a  single  slide. 

Prognosis.— Favorable  in  mild  infestations,  but  when  large 
numbers  are  present  chronic  catarrh,  or  death  from  obstruc- 
tion is  always  probable. 

Treatment.— As  tsenise,  even  in  mild  infestations,  incon- 
venience the  host  more  or  less,  it  is  advisable  to  treat  them. 
A  further  reason  is  the  possible  infestation  of  man  and  herbiv- 
orous animals  with  the  cyst  form.  Hogs,  sheep,  cattle,  show 
and  hunting  dogs  not  only  improve  in  condition  when  the 
tsenise  are  removed,  but  the  further  propagation  of  tseniasis 
is  correspondingly  reduced. 


NEMATODA  201 

The  administration  of  a  tueniafuge  should  be  preceded  by  a 
purgative  and  a  twenty-four  hour  fast.  Many  preparations 
have  been  employed  with  good  results,  but  male  fern  is 
probably  one  of  the  most  reliable.  The  oleoresin  (small  dogs, 
0.5-1.0;  large  dogs,  2.0-5.0;  cats,  0.2-0.5)  may  be  used.  An 
excellent  mode  of  administration  is  to  mix  it  with  a  dose  of 
castor  oil.  The  purgative  action  of  the  oil  assists  in  the 
evacuation  of  the  parasites.  Kamala  (dogs,  3.0-10.0;  cats, 
1.0-4.0)  is  good;  it  also  produces  a  purgative  action.  Areca 
nut  powder  is  often  used  and  is  given  in  doses  of  two  grains 
per  pound  weight  of  the  animal.  It  may  be  given  with 
soup,  ordinary  food  or  milk,  after  the  bowels  have  been 
emptied  by  a  purgative.  Areca  nut  powder  may  be  repeated 
in  a  few  days.  Rabbits  may  be  given  kamala  (0.5-1.0)  in 
the  feed.  Birds  are  best  treated  for  taeniasis  by  mixing  areca 
nut  powder  (chickens,  2.0;  geese,  4.0;  young  chickens,  1.0) 
with  the  feed.  Oil  of  anise  is  also  good,  and  can  be  adminis- 
tered in  0.9-1.0  doses  to  adult  birds. 

NEMATODA. 

Round  Worms.—  A scaridce.— Round  worms  are  quite  com- 
mon in  dogs  and  cats,  especially  in  puppies  and  kittens  two 
or  three  months  old.  Fully  50  per  cent,  are  infested.  In  one 
animal  ten  to  thirty  parasites  are  usually  present;  eighty  were 
found  in  one  subject. 

Round  worms  do  not  require  an  intermediate  host  to  com- 
plete their  life  cycle  as  do  the  tsenise.  The  ova  deposited  by 
the  adult  worm  with  the  feces  are  passed  out,  and  in  warm, 
damp  ground  or  in  other  suitable  places  undergo  certain 
changes,  leading  to  the  formation  of  embryos.  Such  changes 
may  occupy  a  few  days  to  several  weeks,  depending  upon 
the  conditions  of  moisture  and  temperature.  The  embryos 
when  ingested  by  their  particular  host,  rapidly  develop  into 
the  adult  parasite.  Puppies  and  kittens  become  infested 
as  soon  as  they  begin  nursing,  provided  these  parasites  are 
present  in  the  mother  or  other  animals  in  the  kennel.  The 
adult  worms  pass  continuously  a  large  number  of  ova,  and 
embryos  are  present  in  infested  soil  which  adhere  to  the 


202  PARASITES  IN   THE  INTESTINES 

mammary  glands  and  are  swallowed  by  the  young  while 
nursing.  Birds  are  less  commonly  affected  with  round  worms, 
and  as  a  rule  they  harbor  only  a  few  specimens.  Occasionally, 
however,  round  worms  are  found  in  birds  in  large  numbers, 
especially  in  certain  localities  where  this  form  of  parasitism 
may  be  enzootic.  Pigeons  are  the  common  victims;  in  some 
cases  whole  flocks  succumb  to  the  infestation. 

Round  Worms  in  the  Intestine  of  the  Dog.—Belascaris 
marginata.— This  species  is  similar  to  the  B.  mystax  of  the 
cat,  and  is  somewhat  larger.  The  body  is  white  or  reddish, 
head  usually  curved  and  provided  with  two  membranous 
lateral  wings,  which  cause  it  to  look  like  an  arrow  head. 
Male  5  to  10  cm.  long,  tail  curved.  Female  slightly  longer, 
tail  obtuse.  Ova  almost  globular  and  75  to  80  microns  in 
diameter.  Capsule  thick  and  showing  circular  striations; 
granular  center  with  small  clear  space  between  it  and  the 
capsule 

Toxascaris  limbata  (T.  marginata). — This  parasite  is  simi- 
lar to  the  above;  found  in  intestinal  tract  of  dogs;  rare  in 
United  States. 

Echinorhynchus  canis.—  Occasionally  found  in  the  dog  in 
certain  districts  (Texas). 

Round  Worms  in  the  Intestine  of  the  CaA.—Belascaris 
mystax.— This  round  worm  is  slightly  smaller  than  the  B. 
marginata  of  the  dog,  the  male  being  4  to  6  cm.,  the  female 
4  to  10  cm.  long.  Ova  slightly  smaller  than  B.  marginata, 
60  to  75  microns  in  diameter.  Similar  to  B.  marginata  only 
smaller. 

Round  Worms  in  the  Intestine  of  the  Rabbit.— Oxyuris 
ambigua  (Passolurus  ambigus).—Th'is  is  a  white  fusiform 
worm,  male  3  to  5  mm.  long,  female  8  to  11  mm.  The  body 
of  both  sexes  terminates  in  a  suddenly  tapering  tail,  0.22  mm. 
in  length.  It  infests  the  large  intestine  and  cecum.  It  is  not 
so  common  as  the  round  worm  of  the  dog  and  cat,  nor  does 
it  occur  in  as  large  numbers.  Ova  globular  and  very  small, 
with  thick  capsule  similar  to  B.  marginata. 

Round  Worms  in  the  Intestine  of  Birds.— Heterakidce.— 
(a)  Heterakis  papittosa  (Heterakis  vesicularis).—This  is  a 
common  species  infesting  chickens,  and  occasionally  ducks. 


NEMATODA  203 

Male  is  8  to  9  mm.,  female  11  to  15  mm.  long.  Mouth  sur- 
rounded by  three  distinct  lips.  The  body  is  gradually  attenu- 
ated toward  the  posterior  part,  and  has  two  unequal  spicules. 
This  parasite  is  found  exclusively  in  the  caeca  and  occasion- 
ally in  large  numbers.  Ova  are  elongated,  capsule  with  full 
granular  center. 

(6)  Heterakis  di/erens.—This  species  is  slightly  larger  than 
the  Heterakis  papillosa  attaining  a  length  of  15  to  20  mm. 
The  mouth  has  no  apparent  lips.  Has  two  spicules  of  equal 
length  and  the  posterior  extremity  of  the  female  terminates 
in  a  sharp  point.  It  is  usually  found  in  the  posterior  part  of 
the  intestine  of  chickens.  Ova  similar  to  H.  papillosa. 

(c)  Heterakisinflexa  (Heterakis  perspicillutii).—rY\i\'s  is  not 
very  common,  and  when  present  is  found  in  the  small  intes- 
tines.    In  length   and   appearance   it  is  similar  to  the.  H. 
differens.     The  host  is  the  ordinary  fowl. 

(d)  Heterakis  compressa  is  similar  to  above;  occasionally 
found  in  the  small  intestines  of  chickens. 

(e)  Heterakis  muculosa. — This  is  the  common  parasite  of 
pigeons  and  often  occurs  in  such  large  numbers  as  to  prevent 
their  being  reared,  400  to  500  are  sometimes  found  in  an 
individual.    The  body  is  white  and  attenuated  at  both  ends. 
Male  is  20-25  mm.;  female  20-25  mm.  long. 

(/)  Heterakis  crassa.—  This  parasite  is  common  in  the 
duck.  The  male  is  12  to  15  mm.  long  and  the  female  40  to 
50  mm.  Tail  is  thin,  conical,  and  straight. 

(g)  Heterakis  lineata.— Heterakis  lineata  is  rare;  found  in 
the  intestine  of  the  domesticated  duck.  Its  length  is  from  6 
to  10  cm. 

(h)  Heterakis  d  is  par.— This  species  found  in  small  intes- 
tine of  geese  is  closely  related  and  similar  to  the  H.  papillosa. 
Mouth  has  three  very  small  lobes.  Two  lateral  wings  on  the 
neck  becoming  narrower  toward  the  tail.  Male  12  to  IS  mm., 
female  16  to  23  mm.  long.  This  parasite  is  not  very  common. 

Pathology.— Young  animals  which  have  died  from  the  dis- 
order caused  by  the  ascarides,  show  on  autopsy  large  numbers 
of  this  parasite  which  almost  occlude  the  lumen  of  the  bowel. 
The  stomach  may  also  contain  many  of  them.  They  are 
found  scattered  along  the  intestines  or  coiled  up  in  masses. 


204  PARASITES  IN   THE  INTESTINES 

The  mucous  membrane  shows  a  severe  enteritis  with  numer- 
ous ecchymoses  and  many  small  ulcerations.  The  intestines 
contain  no  food,  only  a  slimy  mucus  in  which  are  found  the 
parasites.  In  older  dogs  the  parasites  are  fewer  in  number 
and  are  found  scattered  along  the  entire  length  of  the  intes- 
tine and  rarely  cause  much  change  in  the  mucosa. 

Symptoms.— Puppies  and  kittens  when  infested  show 
symptoms  of  inanition  at  three  to  five  weeks  of  age.  They 
are  stupid  and  do  not  play  as  such  animals  usually  do  at  this 
age.  Vomiting  is  common  and  quite  often  some  of  the  para- 
sites are  thus  expelled.  Emaciation  increases,  the  mucous 
membranes  are  anemic,  and  the  abdomen  appears  enlarged 
("pot  bellied").  Diarrhea  is  not  uncommon,  often  alternat- 
ing with  constipation.  Quite  frequently  the  patients,  espe- 
cially kittens,  show  epileptiform  or  rabiform  symptoms. 
These  are  probably  due  to  the  irritation  of  the  nervous  system 
produced  by  toxins  excreted  by  the  parasites  as  well  as  by 
the  irritation  of  the  intestines  they  produce.  These  symp- 
toms gradually  become  more  severe,  and  finally  food  is 
refused,  followed  by  weakness,  coma  and  death  in  five  to 
eight  weeks.  The  temperature  is  only  slightly  elevated  in 
the  early  stages,  later  as  coma  comes  on  it  is  subnormal. 

In  mild  cases  or  in  older  dogs  the  symptoms  are  less 
intensive,  and  often  unnoticed.  The  appetite  remains  good, 
often  voracious,  but  the  general  condition  is  not  the  best; 
the  hair  coat  dull  and  rough  and  the  growth  impaired. 
Young  birds  infested  with  round  worms  show  diarrhea, 
emaciation  and  depression,  finally  resulting  in  death.  In 
older  birds  the  condition  becomes  chronic  with  marked  ema- 
ciation. 

Diagnosis.— This  can  only  be  positively  made  by  finding 
the  ova  in  the  feces  or  the  parasites  in  the  feces  or  vomitus;  or 
on  postmortem  examination.  (See  Diagnosis  of  Tseniasis.) 
The  general  symptoms  are  similar  to  those  of  tseniasis. 
Ascariasis  is,  however,  more  common  in  very  young  animals 
which  have  had  no  meat.  When  several  animals  or  birds  are 
affected  one  or  more  of  the  typical  cases  should  be  killed 
and  a  careful  autopsy  made. 


NEMATODA  205 

Prognosis.— Severe  infestation  in  young  animals  is  very 
unfavorable.  Ascariasis  causes  greater  loss  among  puppies 
and  kittens  than  any  other  disease.  Entire  litters  often 
succumb  at  four  to  eight  weeks  of  age,  and  in  some  kennels 
it  is  almost  impossible  to  rear  young  animals  due  to  this 
parasite.  Chicks  and  young  birds  usually  succumb;  while' 
older  birds  do  not  die,  they  grow  emaciated  and  droopy  and 
become  an  easy  prey  for  other  diseases. 

Treatment.— Medical.— It  is  advisable  to  administer  a 
vermicide  to  all  puppies  and  kittens  when  three  to  five 
weeks  of  age,  and  repeat  every  two  to  four  weeks  until  several 
months  old.  Treatment  should  be  given  as  soon  as  symp- 
toms appear.  Santonin  (puppies,  0.016;  small  dogs,  0.05-0.2; 
large  dogs,  0.2-0.5;  kittens,  0.008-0.025;  cats,  0.06-0.2)  is  the 
most  efficient  agent  used  to  remove  the  ascaridae.  It  is  best 
administered  in  small  doses,  repeated  for  three  or  four  days, 
than  in  a  single,  large  dose.  This  is  especially  true  for  all 
young  animals,  as  they  are  very  susceptible  to  the  toxic 
action  of  this  drug.  Older  animals  are  rarely  affected  even 
with  enormous  doses.  Santonin  may  be  administered  in 
castor  oil  in  sufficient  amount  to  produce  catharsis,  or  the 
oil  may  be  given  an  hour  or  two  later.  Tablets  of  santonin 
and  calomel  of  various  proportions  may  be  had  and  are 
convenient  to  use  with  the  food.  Other  anthelmintics  are 
employed  with  good  results,  such  as  areca  nut  powder  (dogs, 
0.5-4.0;  cats,  0.1-2.0)  which  is  easily  given  with  milk;  ben- 
zine (1.0-7.0  in  oil) ;  kamala  (2.0-8.0).  Birds  may  be  treated 
with  areca  nut  powder  (chickens  3.0,  pigeons  1.0  each), 
mixed  with  moist  ground  feed.  Oil  of  anise  (0.4-0.8)  or 
benzine  (0.2-0.6)  in  castor  oil  has  been  used  with  good 
results. 

Prevention.— In  order  to  rear  young  animals  free  from 
these  parasites  energetic  measures  must  be  directed  toward 
the  removal  of  all  ascarida*  from  the  older  animals  and  a 
thorough  disinfection  of  all  the  premises  to  which  they  have 
access.  This  is  best  done  in  the  early  winter,  the  weather 
conditions  at  this  time  being  unfavorable  to  their  develop- 
ment. Frequent  examinations  of  the  feces  should  be  made 
and  treatment  applied  when  necessary.  All  additions  to 


206       PARASITES  IN  THE  INTESTINES 

the  kennel  or  flock  should  be  examined  and  treated  before 
being  allowed  with  the  other  animals  or  birds. 

Pregnant  animals  should  be  entirely  freed  of  all  parasites, 
and  thoroughly  washed  to  remove  all  ova  or  embryos  that 
may  be  on  the  hair  or  skin.  Afterward  remove  to  a  clean 
place  that  has  not  been  used  for  animals  for  some  time  where 
the  mother  and  young  should  be  kept  for  several  weeks. 
The  feed  and  water,  and  all  receptacles  must  not  be  per- 
mitted to  be  soiled  by  other  animals  which  harbor  parasites. 
In  this  way  it  is  possible  to  rear  puppies,  kittens  or  birds 
without  experiencing  the  trouble  with  parasites. 

Strongylidse. — Hookworm. — This  species  of  the  nematodes 
inhabits  the  small  intestines,  preferring  the  anterior  half, 
and  occasionally  is  found  in  the  stomach.  They  attach 
themselves  to  the  intestinal  walls,  wound  the  mucosa,  eat 
the  epithelium,  and  suck  the  blood.  According  to  present 
evidence  they  produce  a  poisonous  substance  which  inhibits 
the  coagulation  of  blood  and  possibly  also  injures  the  host. 
Inasmuch  as  these  parasites  frequently  move  from  place 
to  place,  wounding  the  mucous  membrane  in  many  different 
places,  from  which  hemorrhage  continues  for  some  time,  a 
severe  anemia  is  soon  produced.  These  continued  injuries 
to  the  mucosa  soon  result  in  a  severe  enteritis  with  all  of 
the  symptoms  of  inanition. 

The  adult  parasite  in  the  intestine  lays  numerous  eggs 
which  are  passed  out  with  the  fecal  material.  After  a  short 
time  (eight  hours  to  several  days),  the  period  varying  accord- 
ing to  conditions  of  heat  and  moisture,  an  embryo  develops 
in  each  egg.  The  embryo  soon  breaks  through  the  shell.  In 
the  soil  it  undergoes  a  change  in  two  or  three  days,  and 
another  in  about  a  week,  during  which  time  it  also  becomes 
larger.  This  stage  is  known  as  the  infesting  stage.  The 
parasite  may  live  in  this  condition  for  five  months  or  longer. 
Infestation  may  occur  via  the  mouth,  the  embryo  being 
taken  with  the  food  or  drink;  also  by  burrowing  through 
the  skin  or  mucous  membrane  and  by  following  the  blood 
stream  finally  reaching  the  intestines.  In  experimental 
cases  the  worm  has  been  found  in  the  intestines  in  eight  to 
fourteen  days  after  skin  infestation.  t 


NEMATODA  207 

Strongylidae  in  the  Intestine  of  the  Dog.  — (a)  Ankylos- 
toma  canina  (Uncinaria  trigonacephala;  Dochmins  trigona- 
cephalus] .— This  parasite  is  small,  being  10  to  15  mm. 
long,  the  body  white,  mouth  slightly  expanded,  the  ven- 
tral border  or  jaw  terminating  in  four  hook-shaped  pro- 
jections arranged  in  pairs,  and  usually  called  lips,  by  means 
of  which  the  worm  attaches  itself  to  the  mucous  membrane. 
Within  the  mouth  on  the  median  line  is  a  conical  tooth-like 
projection,  on  the  summit  of  which  a  gland  opens.  On  the 
dorsal  border  there  are  in  addition,  two  small  straight  teeth. 
The  tail  of  the  male  is  expanded,  while  that  of  the  female 
terminates  in  a  blunt  point.  The  vulva  is  at  the  posterior 
third  of  the  body.  Ova  ovoid,  74  to  84  microns  long  by  48 
to  54  microns  broad. 

(6)  Uncinaria  stenocephala  (Anhylostomum  stenocephalum). 
-This  species  of  the  strongylidse  is  smaller  than  the  above 
and  less  common.  Body  is  thinner  than  that  of  the  Anky- 
lostomum  canina.  Head  is  narrow,  buccal  capsule  having  on 
each  side  of  its  ventral  aspect  a  sharp  bordered  "lip,"  back 
of  which  is  a  hook-shaped  tooth.  The  dorsal  border  has 
no  teeth.  The  male  is  6  to  8  mm.  long,  female  8  to  10 
mm.  Ova  ovoid,  63  to  67  microns  long  by  32  to  38  microns 
broad. 

Strongylidse  in  the  Intestine  of  the  Ca,t.—Ankylostomum 
trigonacephalum. — This  parasite  has  been  described  under 
the  name  of  Dochmius  balsami.  It  is  almost,  if  not,  identical 
with  the  Ankylostoma  canina  of  dogs  as  described  above. 
They  often  occur  in  larger  numbers  in  cats,  and  may 
localize  at  one  particular  part  of  the  small  intestine. 

Strongylidae  in  the  Intestine  of  the  Rabbit.  — (a)  Strmigy- 
hrides  longus.—1\\is  species  inhabits  the  anterior  part  of  the 
small  intestines.  It  is  a  very  small  worm,  and  the  mouth 
has  no  hooks.  Eggs  are  ovoid,  40  microns  long  and  20 
microns  wide. 

(b)  Strongylus  strigosus.—  This  is  a  rare  species  and  inhabits 
the  cecum  and  colon  of  the  rabbit.  In  rabbits  the  parasite 
has  not  been  known  as  yet  to  produce  any  serious  pathogenic 
conditions. 


208       PARASITES  IN  THE  INTESTINES 

Pathology.— On  autopsy  dogs  which  have  died  from  ankylo- 
stomiasis  show  cachexia.  In  addition  the  mucous  membrane 
of  the  small  intestines  and  cecum  is  very  much  thickened. 
Small  hemorrhagic  areas  are  scattered  over  it,  and  often  so 
extensively  as  to  be  visible  on  the  peritoneal  surface  of  the 
intestine.  The  villi  are  quintuple  their  normal  size,  are 
highly  injected  and  closely  packed  together.  In  the  rela- 
tively healthy  parts  are  seen  a  multitude  of  small  hemor- 
rhagic points,  and  in  their  centers  or  vicinity  are  noted  one 
or  more  of  the  parasites,  often  coupled.  More  parasites  are 
found  in  dogs  that  have  been  ill  only  a  short  time  than  in 
those  in  which  the  malady  is  chronic.  In  the  latter  only  a 
few  parasites  may  be  found  in  the  ileum,  a  circumstance  which 
may  raise  a  doubt  as  to  the  anemia  being  due  to  them. 
Only  a  small  amount  of  very  dark  or  black  fecal  material 
will  be  found  in  the  intestines. 

Symptoms.—  The  symptoms  are  those  of  a  severe  anemia. 
At  first  there  is  only  debility  and  wasting,  although  the 
appetite  remains  good,  though  at  times  variable.  The 
animals  affected  appear  dull  and  indifferent,  the  hair  coat 
is  rough  and  staring,  and  the  skin  scaly  or  reddened  with 
erythematous  patches,  especially  at  the  stifles  and  nose. 
The  latter  is  tumefied,  cracked,  rough  and  excoriated,  with 
a  mucopurulent  discharge  from  the  nostrils.  Attacks  of 
epistaxis  occur  at  intervals  of  a  few  to  several  days  with  a 
loss  of  two  or  three  ounces  of  blood.  Another  important 
symptom  is  edema  of  the  limbs.  It  is  at  first  intermittent, 
but  finally  becomes  quite  permanent.  In  the  latter  stages 
the  diarrhea,  at  first  intermittent,  becomes  continuous,  and 
the  appetite,  which  was  capric'ous,  disappears.  The  animals, 
feeble  and  emaciated,  remain  in  a  lying  position,  grow  coma- 
tose and  die  sometimes  in  convulsions.  Death  takes  place  in 
from  a  few  months  to  a  year. 

Diagnosis  — Ankylostomiasis  is  easily  mistaken  for  non- 
parasitic  anemia.  The  diagnosis  really  depends  upon  the 
finding  of  the  ova  or  the  parasites.  When  several  animals 
in  a  kennel  or  pack  are  affected,  an  autopsy  will  remove  all 
doubt  as  to  the  nature  of  the  malady. 


NEMATODA  209 

Prognosis.— If  the  condition  is  recognized  early  and  treat- 
ment administered,  the  prognosis  is  favorable.  In  those 
cases  showing  extreme  emaciation  and  exhaustion  the  prog- 
nosis is  bad. 

Treatment.— Treatment     in     ankylostomiasis     must     be 
directed  toward  the  removal  of  the  parasite.    The  common 
anthelmintics  used  for  intestinal  parasites  have  little  or 
no  effect  on  the  strongylidse.    Thymol  (0.06-0.6)  is  prob- 
ably the  best  for   this   species,   and   good   results  follow 
its  use  in  daily  repeated    doses.     It  is  advisable  to  pre- 
cede the  treatment  with  a  dose  of  Epsom    salts  to  free 
the  intestines  of  food  and  the  mucus  with  which  the  para- 
sites are  usually  covered.    The  object  of  the  treatment  is  to 
have  the  finely  pulverized  thymol  pass,  only  slightly  dis- 
solved, through  the  entire  length  of  the  intestines,  and  com- 
ing in  contact  with  the  parasites,  destroy,  or  so  disable  them, 
that  they  may  be  evacuated.    As  thymol  is  very  soluble  in 
alcohol,  fats  or  oil,  and  serious  results  follow  its  absorption, 
all  medicines  containing  alcohol  as  well  as  all  fatty  foods 
(fat  meat,  milk,  butter,  etc.)  should  be  avoided  during  its 
use.    It  must  be  administered  in  a  capsule  thoroughly  mixed 
with  three  times  the  amount  of  sugar  to  prevent  the  thymol 
collecting  in  a  mass,  as  it  would  otherwise  do  as  soon  as 
liberated  from  the  capsule  and  pass  through  the  intestine 
with  little  or  no  effect  on  the  parasites.    Should  absorption 
occur  with  the  production  of  toxic  symptoms,  a  subcutaneous 
injection  of  magnesium  sulphate  (0.3)  will  often  overcome  it. 
Nutritious  and  easily  digested  food  (lean  meat,  rice  soup, 
cooked  vegetables)  may  be  given  during  the  treatment  after 
which  the  best  of  food  that  the  dog  will  eat  should  be  allowed. 
Stomachic  tonics  as  iron,  quinine  citrate  (0.2-0.3),  tincture 
gentian  compound    (1.0-4.0)   are  useful  to  stimulate  the 
appetite.    These  should  be  continued  for  some  time.    In  a 
few  weeks  make  another  examination  for  parasites  or  ova, 
and,  if  present,  repeat  the  treatment.     Thorough  disinfection 
of  the  kennels  is  important. 

Trichinellidae. —  Whijnvonu. — This  parasite    lives    in   the 
cecum  and  large  intestines,  and  is  less  common  than  the 
species  described.    It  is  also  much  slower  in  development, 
14 


210       PARASITES  IN  THE  INTESTINES 

requiring  three  to  four  months  to  produce  embryos,  which, 
when  introduced  into  the  digestive  tract,  attain  complete 
development  in  two  to  three  months.  The  trichuris  does 
not  require  an  intermediate  host;  embryonic  development 
takes  place  entirely  outside  the  body  and  the  parasite 
must  pass  into  the  digestive  canal  while  still  enveloped  in 
its  shell.  This  species  is  often  found  in  animals  affected  with 
severe  anemia,  but  it  does  not  appear  to  play  other  than  a 
secondary  part  in  the  development  of  the  disease.  When 
present  in  considerable  numbers  in  the  cecum,  however,  it 
may  cause  a  chronic  inflammatory  condition  by  its  repeated 
injuries  to  the  mucosa. 

The  ova  differ  considerably  from  those  of  other  intestinal 
parasites,  being  ovoid,  70  to  80  microns  long  and  30  to  35 
microns  broad,  of  a  distinct  yellow  color,  and  have  at  each 
end  a  small  rounded  projection  which  appears  clear  under  the 
microscope. 

Birds  are  occasionally  infested  but  the  parasite  is  rarely 
present  in  large  numbers,  and  the  anemia  it  produces  is  only 
secondary  to  the  chronic  enteritis  which  results. 

Trichinellidse  in  the  Intestine  of  the  Dog.  —  Trichuris 
depressiuscuhis. — This  species  is  often  spoken  of  as  the 
whipworm,  owing  to  the  resemblance  of  the  body  to  a  whip. 
It  is  45  to  75  mm.  long.  The  anterior  half  of  the  body  is 
much  smaller  than  the  posterior  part  and  the  tail  is  usually 
curved. 

Trichinellide  in  the  Intestine  of  the  Rabbit.  —  Trichuris 
unguiculatus.—This  species  is  rare  and  is  only  occasionally 
found  in  the  large  intestine  and  cecum  of  the  wild  rabbit 
and  the  hare.  The  male  is  3  to  4  cm.,  the  female  3  to 
5  cm.  long. 

Trichinellide  in  the  Intestine  of  Birds.  — (a)  Trichosumum 
retusum.—Msi\e  13  mm.,  female  19  mm.  long.  Body  white 
or  yellowish-white,  tail  blunt. 

(6)  Trichosomum  annulatum.—M.a\e  15  mm.,  female  80 
mm.  long.  Body  white  and  very  attenuated  at  its  anterior 
extremity  and  marked  with  close  annular  stripes. 

(c)  Trichosomum  collare.— Male  8  to  10  mm.,  female  9  to 
12  mm.  long. 


NEMATODA  211 

(d)  Trichosomum   tennissimum. — This   species   has    been 
found  in  pigeons.    It  is  10  to  18  mm.  long. 

(e)  Trichosomum  brevicolle.—M.a\e  10  to  12  mm.,  female 
20  to  24  mm.  long.    This  parasite  is  found  occasionally  in 
the  large  intestine  of  geese. 

Pathology. —These  parasites  are  usually  found  in  the  cecum 
and  large  intestines  but  rarely  in  large  numbers.  In  several 
cases  of  parasitic  anemia  in  which  whipworms  occur  other 
parasites  are  usually  also  present.  The  whipworms  are  found 
partly  coiled  up  and  attached  to  the  mucous  membranes 
of  the  posterior  bowel.  The  mucous  membrane  is  slightly 
thickened  and  shows  small  areas  of  inflammation  from  the 
injury  produced  by  the  parasites. 

Symptoms.— Gradual  emaciation  and  anemia  are  the  prin- 
cipal symptoms.  The  appetite  may  be  variable,  and  con- 
stipation and  diarrhea  alternate. 

General  symptoms  are  rarely  noted,  unless  the  infestation 
has  been  severe  when  general  anemia  occurs.  Birds  are 
more  often  seriously  affected  than  other  animals. 

Diagnosis.— This  depends  entirely  upon  finding  the  para- 
sites or  ova  in  the  feces.  (See  Fecal  Examination  for  Para- 
sites.) 

Prognosis.— Favorable  if  the  condition  is  recognized,  treat- 
ment applied  early,  and  before  extreme  emaciation  occurs. 

Treatment.— Thymol,  same  as  for  the  strongylidw. 


CHAPTER  XL 
DISEASES  OF  THE  RECTUM  AND  ANUS. 

Examination.— These  parts  are  quite  readily  examined  in 
all  small  animals.  The  anus  by  inspection  and  palpation 
for  enlargements  and  abscess  formation  in  the  anal  glands, 
congenital  occlusion  in  puppies,  pseudocoprostasis,  inflam- 
mation at  the  anal  opening,  foreign  bodies  and  parasites. 

The  rectum  is  best  examined  as  follows:  (a)  Direct 
palpation.  The  index  finger  is  inserted  as  far  as  possible  to 
determine  the  condition  of  the  mucosa,  the  presence  of 
foreign  bodies,  parasites,  fecal  matter,  blood,  etc.  (6)  A 
rectal  speculum  is  used  to  dilate  the  anus  and  rectum.  By 
using  reflected  light  (mirror)  the  mucosa  can  be  directly 
examined  for  inflammations,  tumors,  parasites,  foreign  bodies 
etc.  (c)  Palpation  through  the  abdominal  walls  will  admit 
of  an  examination  of  the  anterior  portion  of  the  rectum.  It 
can  easily  be  distinguished  from  the  other  tissues,  and  quite 
readily  inspected  in  this  location  for  fecal  accumulations, 
foreign  bodies,  etc.  (d)  Laparotomy  when  performed  just 
anterior  to  the  pubis,  in  the  median  line  of  females,  and  to 
either  side  of  the  penis  in  males,  will  allow  direct  inspection 
of  the  rectum  for  inflammations,  tumors,  fecal  accumula- 
tions, etc. 

OCCLUSION  OF  THE  RECTUM  AND  ANUS. 

(a)  A  congenital  occlusion  of  the  rectum  and  anus  has  been 
observed  quite  frequently  in  puppies.  Imperforate  anus  is 
most  common.  This  condition  exists  at  birth  and  is  the 
result  of  improper  development  during  fetal  life.  The  rectum 
is  formed  from  the  hypoblastic  and  mesoblastic  embryonic- 
layers  while  the  anus  is  developed  by  the  imagination  of  the 
epiblastic  which,  as  the  development  progresses,  joins  the 
rectum  by  absorption  of  the  intervening  septum.  Anything 


OCCLUSION  OF  THE  RECTUM  AND  ANUS        213 

which  interferes  with  the  normal  development  would  pro- 
duce imperf  orate  anus.  Sometimes  the  fetal  development 
will  be  interfered  with  sufficiently  to  produce  occlusion  of 
both  the  rectum  and  anus. 

(6)  An  artificial  occlusion  of  the  rectum  and  anus  (pseudo- 
coprostasis)  occurs  occasionally  in  long  haired  dogs  (poodles), 
birds  and  cats  (angoras)  from  the  hair  or  feathers  becoming 
agglutinated  with  fecal  matter  which  becomes  dry  and  forms 
a  firm  film  or  plaster  over  the  anal  opening  interfering  with 
defecation.  Also  occasionally  foreign  bodies  (splinters  of 
bone,  needles,  pins,  etc.)  are  found  which  have  successfully 
passed  other  portions  of  the  alimentary  tract  only  to  become 
lodged  at  or  near  the  anal  opening  interfering  with  the  pas- 
sage of  the  feces. 

Symptoms.— The  congenital  occlusion  is  seldom  observed 
until  there  is  persistent  and  ineffectual  attempts  at  defeca- 
tion. Puppies  when  examined  carefully  will  be  found  to 
have  the  rectum  distended  with  feces  and  an  absence  of  an 
anal  opening,  the  skin  being  pouched  out  where  the  anal 
opening  should  be.  However,  should  the  rectum  and  anus 
both  be  imperf  orate  the  enlargement  will  be  absent.  The 
abdomen  becomes  distended,  and  they  refuse  to  nurse. 
A  careful  examination  will  at  once  reveal  the  condition. 
There  is  more  difficulty  in  recognizing  an  occlusion  of  the 
rectum,  but  by  passing  a  small  probe  or  sound  the  condition 
can  be  definitely  determined. 

In  artificial  occlusion  (pseudocoprostasis)  the  principal 
symptom  is  the  persistent  attempts  at  defecation  without 
the  passage  of  fecal  matter.  A  careful  inspection  of  the  anal 
region  will  at  once  reveal  a  collection  of  feces  and  the  matted 
hair  or  feathers.  This  condition  if  persistent  will  produce 
symptoms  similar  to  constipation  or  obstipation.  (See  Con- 
stipation.) 

Diagnosis.— The  diagnosis  is  quite  readily  established  by 
a  careful  inspection  of  the  parts  involved. 

Prognosis.— Favorable,  except  in  congenital  deformity  of 
the  rectum. 

Treatment.  — In  imperforate  anus,  an  X-shaped  incision 
should  be  made  over  the  point  distended  by  the  feces.  <  'are 


214  DISEASES  OF  THE  RECTUM  AND  ANUS 

should  be  taken  to  prevent  injuring  the  sphincter  muscle. 
The  flaps  of  skin  should  be  either  trimmed  off  to  form  a 
circular  opening,  or  stitched  back  to  prevent  adhesions  taking 
place.  The  passage  of  a  small  sound  daily,  keeping  the  edges 
of  the  wound  well  lubricated  with  vaseline,  or  the  direct 
application  of  silver  nitrate  ever}'  day  or  two,  will  prevent 
adhesions.  In  cases  where  the  rectum  is  also  involved, 
treatment  is  not  to  be  attempted. 

Artificial  occlusion  from  collections  of  feces  can  be  removed 
by  clipping  away  the  hair  or  feathers  from  around  the  anal 
opening,  softening  the  hardened  mass  by  the  use  of  warm 
water,  and  administering  a  purgative  or  allowing  laxative 
foods  for  a  few  days. 

When  foreign  bodies  are  present,  a  careful  examination 
should  be  made  to  determine  their  size  and  character.  They 
should  be  removed  carefully  to  prevent  laceration  of  the 
tissues. 

A  purgative  is  advisable,  and  if  the  foreign  body  has  led 
to  atony  of  the  walls  of  the  lower  bowels,  small  doses  of 
strychnin  sulphate  (0.0005-0.001)  should  be  administered 
daily. 

PROCTITIS. 

Definition.— An  acute  inflammation  of  the  mucous  mem- 
brane of  the  rectum. 

Etiology.  — Proctitis  is  observed  quite  commonly  in  the 
dog  and  cat  and  results  usually  from  the  same  causes  that 
produce  inflammation  of  other  parts  of  the  alimentary  tract. 
Also,  it  occurs  frequently  from  direct  injuries,  such  as  inser- 
tion of  the  thermometer,  careless  manipulation  \vith  the 
finger,  frequent  passing  of  catheters  or  sounds,  or  the  injec- 
tions of  too  strong  antiseptic  solutions  or  soapy  water,  etc. 
All  of  these  conditions  will  produce  a  more  or  less  severe 
proctitis  depending  upon  the  amount  of  injury  done  to  the 
mucosa. 

Pathology.— The  mucous  membrane  becomes  reddened 
and  congested,  especially  at  the  apex  of  the  folds;  hemor- 
rhages and  erosions  are  often  observed.  Hemorrhages  take 
place  from  the  mucous  membrane,  and  occasionally  small  or 


PROCTITIS  215 

copious  quantities  are  ejected  from  the  rectum.  In  severe 
forms,  due  to  poisons,  infections,  etc.,  the  epithelium  becomes 
desquamated,  and  quantities  of  it  will  become  loosened  from 
the  submucosa.  Further,  when  due  to  injuries,  the  lesions 
are  usually  confined  to  the  lower  part  of  the  rectum,  and 
depend  upon  the  extent  of  injury. 

Symptoms.— Difficult  and  painful  defecation  with  frequent 
attempts  at  defecating  and  only  a  small  quantity  of  feces 
being  passed.  The  feces  are  streaked  or  covered  with  blood. 
Edema  of  the  mucosa,  which  can  be  seen  slightly  pouching 
out  through  the  anal  opening.  Direct  examination  reveals 
the  painful,  inflamed  mucous  membrane.  Digital  examina- 
tion produces  severe  pain.  Through  the  rectal  speculum  the 
mucous  membrane  will  be  found  highly  congested,  swollen 
and  the  surface  covered  with  dark,  bloody  fecal  matter. 

Diagnosis.— This  is  not  difficult  as  a  direct  examination 
will  readily  detect  the  inflammatory  condition. 

Prognosis.— Usually  favorable  when  localized  in  the  rectum. 
However,  a  careful  examination  should  be  made  of  the  other 
portions  of  the  digestive  tract  before  a  positive  prognosis  is 
made.  It  depends  also  somewhat  upon  the  cause  and  the 
extent  of  injury  to  the  mucosa  and  the  adjacent  structures. 

Treatment. —The  cause  should  first  be  found  if  possible, 
and  removed,  to  prevent  further  injury  and  irritation  to  the 
mucous  membrane. 

Rectal  injections  of  mild  astringent  and  antiseptic  solutions 
(alum  1-2  per  cent.,  boric  acid  2  per  cent.)  are  indicated. 
These  should  be  introduced  with  a  syringe  having  a  blunt, 
well  rounded  nozzle,  and  the  injection  made  slowly  only  a 
small  quantity  at  each  time.  The  fluid  should  be  at  or  near 
the  body  temperature  to  avoid  straining. 

Tincture  of  opium  is  indicated  as  an  injection  when  pain 
is  severe,  to  allay  irritation  and  to  prevent  straining.  A 
solution  of  one  part  tincture  opium  to  thirty  parts  water  will 
be  found  useful  for  this  condition.  This  injection  should  be 
repeated  as  often  as  necessary. 

In  some  cases  it  is  advisable,  where  irritants  are  sus- 
pected of  being  present,  to  irrigate  the  rectum  with  warm 
water  or  a  bicarbonate  of  soda  solution  (2  per  cent.)- 


216          DISEASES  OF  THE  RECTUM  AND  ANUS 

HEMORRHOIDS.  PILES. 

Definition. — Hemorrhoids  are  varicose  or  dilated  veins  of 
the  hemorrhoidal  plexus.  According  to  their  location  they 
are  termed  external,  internal  or  mixed.  External  hemor- 
rhoids are  located  outside  the  sphincter  ani  and  in  the  sub- 
cutaneous tissue,  while  internal  hemorrhoids  are  located 
inside  the  sphincter  muscle  and  under  the  mucous  membrane. 
The  mixed  variety  consists  of  both  of  the  above  appearing 
at  the  same  time. 

Etiology.— This  condition  is  commonest  in  old  dogs,  and 
results  most  frequently  from  obstructions  to  the  portal 
circulation,  through  constipation,  congestion  of  the  liver, 
proctitis,  enlarged  prostate  glands,  or  chronic  cardiac  dis- 
eases. All  of  these  conditions,  from  a  defective  circulation 
to  the  parts  involved,  lead  to  a  venous  stasis  with  a  resultant 
distention  of  the  veins  of  the  hemorrhoidal  plexus. 

Pathology.— The  external  variety  is  usually  made  up 
chiefly  of  hypertrophied  perirectal  connective  tissue,  appear- 
ing as  small  cutaneous  projections,  involving  the  external 
veins,  which  become  distended  or  rupture,  forming  a  soft 
tumor-like  mass.  The  internal  variety  consists  of  numerous 
distended  vessels,  increased  connective  tissue  formation, 
which  often  show  an  ulcerating  surface,  and  are  sometimes 
found  projecting  through  the  anal  opening.  Hemorrhages 
often  take  place  readily  from  them,  through  irritation  by  the 
passage  of  fecal  material. 

Symptoms.— The  act  of  defecation  is  usually  very  painful, 
the  feces  being  covered  with  blood,  or  a  quantity  of  blood 
passed  following  the  feces.  Sometimes  defecation  is  stopped 
entirely  from  the  severe  pain  which  is  induced  by  it.  Pruritus 
is  also  a  prominent  symptom,  the  animal  biting  or  licking  the 
parts,  or  sliding  the  anus  along  the  floor.  Direct  inspection 
of  the  parts  reveals  the  presence  of  the  hemorrhoidal  enlarge- 
ments, which  appear  as  bluish-red  knots  encircling  the  rec- 
tum. If  external,  the  enlargements  will  be  noticed  on  e  ther 
side  of  the  anal  opening.  Hectal  examination  is  very  painful 
(different  from  rectal  polypi,  or  other  neoplasms,  which  are 
occasionally  found  in  this  location). 


PROLAPSE  OF  THE  RECTUM  217 

Diagnosis. —This  is  usually  not  difficult,  as  the  parts  can 
be  readily  inspected. 

Prognosis.— When  appearing  in  old  animals  a  complete 
recovery  seldom  takes  place  as  the  causes  are  difficult  to 
eliminate.  However,  in  recent  cases,  or  in  younger  animals, 
the  prognosis  is  more  favorable,  as  a  number  of  the  cases  are 
amenable  to  treatment. 

Treatment. — The  early  indications  in  the  treatment  are  to 
regulate  the  bowels  by  the  use  of  saline  laxatives  (magnesium 
sulphate,  dog  8.0-12.0),  and  laxative  foods  (soups,  etc.)  to 
overcome  constipation. 

Enemas  of  cold  water  are  also  useful  to  relieve  the  con- 
gestion and  irritation.  Zinc  oxid  ointment  will  also  be  found 
valuable  for  its  astringent  and  lubricating  properties. 

Should  the  internal  hemorrhoids  protrude  into  the  canal 
or  through  the  anal  opening,  they  should  be  grasped  with 
the  forceps,  drawn  out  through  the  anal  opening,  and 
ligated  (see  Prolapse  of  the  Rectum).  In  some  cases  where 
ligation  is  impracticable,  the  rectum  is  dilated  with  a  specu- 
lum and  the  actual  cautery  applied,  care  being  taken  to 
prevent  injuring  the  adjacent  tissues. 

In  external  hemorrhoids,  it  is  advisable  to  operate  by 
dissecting  around  them  carefully,  ligating  them  firmly  at  the 
base  with  sterile  silk  or  linen,  removing  the  ligated  portion 
and  suturing  the  skin  wound.  Should  blood  clots  or  abscesses 
form  they  should  be  opened  and  treated  with  antiseptic- 
solutions. 

PROLAPSE  OF  THE  RECTUM. 

Definition.— An  eversion  of  the  rectal  mucosa,  or  the  entire 
walls  of  the  rectum  through  the  anal  opening. 

Etiology.— An  eversion  of  the  rectal  mucosa  is  very  common 
in  the  dog  and  cat,  and  occurs  most  often  from  a  local  hyper- 
emia  just  anterior  to  the  anal  opening,  the  resultant  swelling 
forcing  the  mucosa  out  through  the  opening.  Or  it  may 
come  from  straining  during  constipation,  diarrhea,  or  the 
presence  of  parasites,  or  foreign  bodies  in  the  rectum.  Rectal 
prolapse  is  observed  very  often  in  puppies  and  kittens,  due 
in  part  to  straining  incident  to  catarrh  of  the  bowels,  presence 


218  DISEASES  OF  THE  RECTUM  AND  ANUS 

of  parasites,  etc.,  and  also  in  part  to  a  weakness  of  the 
sphincter  muscles  or  the  supporting  tissues  of  the  rectum. 

Prolapsus  of  a  part  or  the  entire  rectum  is  also  frequently 
observed,  due  mainly  to  excessive  straining  during  constipa- 
tion, in  diarrhea,  enteritis,  etc.  This  is  common  in  old  dogs 
from  unduly  straining  during  the  course  of  chronic  constipa- 
tion, diarrhea,  hemorrhoids,  urethral  stricture,  enlarged 
prostate  glands,  rectal  tumors,  labor  pains,  or  after  the  use 
of  irritating  or  hot  rectal  injections  or  infusions.  Some- 
times these  causes  not  only  lead  to  prolapsus  or  intussuscep- 
tion of  the  rectum,  but  other  portions  of  the  bowels  may  be 
involved,  and  protrude  out  through  the  anal  opening.  (See 
Intussusception.) 

Symptoms.— Mild  cases  of  eversion  of  the  rectal  mucosa 
are  hardly  noticeable,  except  when  the  animal  strains,  wrhen 
the  enlargement  becomes  visible.  In  more  severe  cases,  the 
rectal  mucosa  will  appear  as  a  rounded,  congested  enlarge- 
ment, protruding  out  through  the  anal  opening.  The  condi- 
tion of  the  mucosa  will  depend  greatly  upon  the  length  of 
time  it  has  been  everted.  On  close  inspection,  the  mucosa 
will  usually  be  found  to  be  everted  only  from  one  side  of  the 
rectum,  or  in  rare  instances  may  be  the  entire  mucosa.  It 
will  be  found  congested,  of  dark  color,  hemorrhagic,  the 
external  covering  desquamated  and  often  hanging  in  thin 
shreds.  Often  the  surface  bleeds  when  the  parts  are  manipu- 
lated. Necrosis  may  result  from  exposure,  or  from  the  blood 
supply  becoming  reduced  by  the  swelling.  An  eversion  of  the 
rectum  will  at  once  be  recognized  by  the  curved,  cylinder- 
like  bowel  which  protrudes.  Some  feces  will  be  passed,  and 
will  collect  around  the  orifice  of  the  canal.  Longer  exposure 
(twenty-four  to  forty-eight  hours)  will  often  lead  to  inqlura- 
tion,  with  foci  of  ulceration,  gangrene,  beginning  as  a  rule  at 
the  apex  of  prolapsed  portion.  The  progressive  changes 
which  develop  will  depend  very  largely  upon  the  length  of 
time  the  bowel  remains  exposed. 

Diagnosis.— This  is  not  difficult  as  a  close  inspection  of  the 
parts  involved  will  at  once  reveal  the  condition. 

Prognosis. — An  eversion  of  the  mucosa  is  always  considered 
favorable,  recovery  taking  place  promptly.  However,  if  the 


PROLAPSE  OF  THE  RECTUM  219 

causes  persist,  in  some  cases  the  eversion  of  the  mucosa  may 
be  followed  by  a  prolapsus  of  the  rectum. 

The  prognosis  in  prolapsus  of  the  rectum  is  usually  favor- 
able, unless  the  bowel  becomes  necrotic,  or  complications 
higher  up  in  the  bowel  take  place  from  infection,  etc.  There- 
fore, the  prognosis  depends  very  largely  upon  the  length  of 
time  the  bowel  has  been  protruded.  When  treated  early  and 
before  pathological  changes  have  developed  in  the  exposed 
bowel,  the  prognosis  should  be  considered  favorable. 

Treatment.— In  the  mild  cases  of  everted  mucosa,  when 
taken  early,  applications  of  cold  water  or  astringent  solutions, 
such  as  alum  (2-5  per  cent.),  are  usually  efficient  in  reducing 
the  size  of  prolapsed  portion  so  that  it  can  be  returned  to  its 
proper  position.  Further  application  of  astringents  will 
assist  in  keeping  it  in  position.  Only  small  quantities  of  the 
solutions  should  be  employed,  owing  to  the  danger  of  induc- 
ing undue  straining.  Should  this  method  fail  in  keeping  the 
mucosa  in  its  proper  position,  it  can  be  grasped  with  small 
dressing  forceps,  pulled  out  gently  and  cauterized  with  the 
thermocautery,  making  two  or  three  longitudinal  lines,  being 
careful  to  prevent  going  through  the  mucosa.  Should  the 
prolapsed  mucosa  show  necrosis,  it  is  best  to  remove  it  in  the 
following  manner:  The  prolapsed  portion  should  be  grasped 
firmly  with  dressing  forceps  and  drawn  out  until  the  normal 
membrane  appears;  it  is  held  in  this  position  and  a  double 
suture  applied  through  the  base  and  tied  either  way  around 
the  enlargement.  The  ligature  should  be  applied  rather 
firmly  to  prevent  hemorrhage  and  retraction  of  the  tissues 
which  would  loosen  it.  The  ligated  portion  is  then  removed 
with  the  scissors.  The  base  is  returned  to  the  rectum  and 
treated  with  antiseptic  and  astringent  solutions. 

Prolapsus  of  the  rectum  is  often  quite  difficult  to  reduce. 
When  taken  early,  before  much  swelling  has  taken  place,  it 
can  usually  be  pushed  back  into  place,  by  digital  kneading, 
or  by  the  use  of  a  bougie  or  a  well  rounded  sound.  Placing 
the  animal  in  a  pendant  position  with  the  head  downward, 
will  assist  in  the  replacement.  When  the  parts  are  in  posi- 
tion, it  is  advisable  to  resort  to  some  method  of  retaining 
them  in  place  for  a  time,  otherwise  they  are  quite  liable  to  be 


220          DISEASES  OF  THE  RECTUM  AND  ANUS 

thrown  out  again  by  the  animal  straining.  A  tobacco-pouch 
suture,  which  is  used  to  constrict  the  anal  opening,  is  often 
used  successfully,  making  the  constriction  just  sufficient  to 
hold  the  parts  in  position,  and  to  allow  soft  or  liquid  feces  to 
be  passed.  However,  as  soon  as  this  suture  is  removed  the 
prolapsus  often  recurs. 

Should  these  methods  fail  to  replace  the  prolapsed  rectum, 
or  hold  it  in  position,  laparotomy  should  be  performed  (see 
Laparotomy),  and  the  prolapsed  bowel  returned  to  its  proper 
position  by  gentle  traction.  Thef  bowel  when  returned  to 
the  cavity  should  be  held  in  place  by  suturing  same  to  the 
abdominal  wall  (ventrofixation) .  The  sutures  should  be 
applied  carefully  so  that  they  only  pass  through  the  serous 
and  muscular  coats  of  the  bowel.  Several  of  these  sutures 
should  be  applied  to  firmly  fix  the  bowel  in  position.  Laxa- 
tives or  laxative  foods  are  indicated  to  prevent  constipation 
and  pressure  on  the  posterior  bowels.  Should  the  prolapsed 
portion  be  much  swollen,  necrotic,  or  severely  inflamed,  this 
method  is  not  advisable,  as  it  would  act  as  a  foreign  body  and 
induce  severe  straining,  resulting  in  a  repetition  of  the  former 
condition.  Should  the  prolapsed  portion  show  evidences  of 
marked  pathological  changes,  it  is  advisable  to  resort  to 
amputation,  which  is  done  in  the  following  manner:  The 
animal  is  given  a  general  anesthetic,  placed  on  the  table  in  a 
ventral  position,  and  the  parts  involved  thoroughly  cleansed 
with  an  antiseptic  solution.  The  prolapsed  bowel  is  then 
grasped  with  a  bowel  clamp,  gentle  traction  used  until 
normal  tissues  appear,  and  a  previously  sterilized  small, 
rubber  tube  applied  close  to  the  anus,  to  act  as  a  tourniquet. 
A  circular  incision  should  be  made  through  the  external 
intestinal  wall,  a  short  distance  posterior  to  the  tourniquet, 
and  parallel  to  the  anal  margin.  Seize  the  severed  external 
tube  at  the  anal  margin  with  small  hemostatic  forceps,  to 
prevent  its  retraction  and  draw  it  out  gently  to  bring  its 
serous  coat  in  contact  with  the  serous  coat  of  the  internal 
tube.  These  two  surfaces  should  be  sutured  using  sterilized 
cat-gut,  silk  or  linen,  making  interrupted  sutures  the  entire 
circumference  of  the  incised  portion,  ("are  should  be  taken 
in  inserting  these  stitches,  as  they  should  only  pass  through 


PARASITES  IN  THE  RECTUM  221 

the  serous  and  muscular  coats.  When  this  is  completed,  the 
outer  tube  is  cut  off  with  the  scissors  distal  but  close  to  the 
row  of  stitches.  The  mucous  surfaces  are  then  approximated 
with  continuous  or  interrupted  sutures,  and  the  stump  thor- 
oughly cleansed  with  antiseptics  and  returned  within  the 
anus. 

Should  hemorrhage  occur  during  the  operation  all  vessels 
should  be  ligated,  as  the  persistent  hemorrhage  interferes 
with  the  application  of  the  sutures.  The  after-treatment 
consists  in  the  daily  injection  of  small  quantities  of  antiseptic 
solutions. 

Another  successful  method  of  procedure  is  to  insert  a  sound 
of  proper  size,  depending  upon  the  size  of  the  animal,  into  the 
lumen  of  the  canal;  apply  a  tourniquet  rather  firmly  around 
the  prolapsed  portion  close  to  the  anal  margin  to  control  the 
hemorrhage,  and  to  prevent  the  wall  from  retracting.  The 
prolapsed  portion  is  then  amputated  rather  close  to  the 
tourniquet.  A  continuous  suture  is  applied  around  the 
margin  of  the  incised  portion,  the  stitches  placed  close  to- 
gether and  including  enough  of  the  tissues  so  that  the  serous 
coats  will  be  brought  in  apposition.  The  tourniquet  and 
sound  are  removed  and  the  stump  replaced  within  the  anus. 
Antiseptic  and  astringent  solutions  should  be  used  for  a  few 
days. 

'PARASITES  IN  THE  RECTUM. 

Parasites  in  the  rectum  are  not  very  numerous,  although 
one  species  is  found  inhabiting  the  posterior  bowels.  Other 
species  are  found  quite  often  in  their  exit  from  the  intestinal 
tract,  especially  tsenise,  ascarides,  etc. 

The  parasites  inhabiting  the  rectum  belong  to  the  Xeina- 
toda  family,  Oxyuridje.  The  following  are  the  ones  most 
often  found : 

(a)  Oxyuris  vennicularis ,  found  in  the  dog.  The  male  is 
2  mm.  to  3  mm.  long,  the  female  9  mm.  to  10  mm.,  the  color 
being  white  and  the  body  expanded  anteriorly. 

(6)  Oxyuri-s  compar,  found  in  the  cat  in  the  small  ami  large 
bowels,  also  in  the  rectum.  The  female  is  8  mm.  to  l.~>  mm. 
long.  Same  characteristics  as  those  found  in  the  dog. 


222  DISEASES  OF  THE  RECTUM  AND  ANUS 

(c)  Oxyuris  ambigua,  found  in  the  rabbit.  The  male  is 
3  mm.  to  5  mm.  long,  and  the  female  8  mm.  to  11  mm.  They 
are  white  fusiform  worms  the  body  terminating  in  a  sublated 
or  suddenly  tapering  tail. 

Sympt Dins.  —These  parasites,  by  producing  irritation  to  the 
rectal  mucosa,  induce  severe  pruritis,  causing  the  animals  to 
bi^e  or  lick  the  anus  and  often  slide  along  on  the  floor  to 
relieve  the  intense  itching.  The  parasites  are  often  seen 
projecting  from  the  anal  opening,  or  observed  being  passed 
with  the  feces.  Aside  from  the  disagreeable  symptoms  in- 
duced they  do  not  effect  much  change  to  the  mucosa,  and  no 
general  symptoms  are  observed. 

Treatment.— Oleaginous  or  saline  infusions  injected  into 
the  rectum  with  a  syringe  are  usually  sufficient  to  destroy 
them.  These  injections  may  be  repeated  every  few  days 
until  the  symptoms  disappear. 

NEOPLASMS  IN  THE  RECTUM. 

Tumors  of  the  rectum  and  around  the  anal  opening  are 
occasionally  observed,  more  commonly  in  dogs  than  in  any  of 
the  other  small  animals.  The  most  common  tumors  found  in 
the  rectum  are  adenocarcinomas  or  adenomas.  Epithe- 
liomas  also  occur  located  outside  the  anus  and  originating 
from  the  skin.  Occasionally  are  found  fibromas  and  sarcomas 
originating  from  the  periproctal  connective  tissue. 

Symptoms. — The  adenomas  or  adenocarcinomas  found  on 
the  rectal  mucosa  or  margin  of  the  anal  opening  interfere 
with  defecation  and  cause  straining.  They  usually  appear  as 
fungus-like  growths  with  ulcerated,  bleeding  surfaces.  Their 
rapid  development  is  characteristic.  Epitheliomas  occur  as 
a  wart-  or  cauliflower-like  growth  with  a  rough  uneven  surface 
situated  in  the  skin  around  the1  margin  of  the  anal  opening 
and  often  involving  the  anus,  skin  and  periproctal  connective 
tissue.  These  vary  in  size,  may  appear  singly  or  multiple 
and  often  show  an  ulcerated  surface,  with  a  fetid  discharge. 
Fibromas  are  usually  quite  large  and  grow  from  the  peri- 
proctal tissue  on  one  side  of  the  anus.  They  may  be  two  or 
three  inches  in  diameter,  and  are  characterized  by  their 


SUPPURATION  OF  THE  ANAL  GLANDS          223 

slow  growth,  smooth  surface  and  firm  consistency.  They 
greatly  interfere  with  defecation. 

Diagnosis.— While  an  approximate  diagnosis  may  be  made 
from  the  symptoms,  the  growth  and  the  general  appearance 
of  enlargement,  an  accurate  diagnosis  depends  upon  the 
microscopical  examination. 

Prognosis.— Obviously  the  prognosis  in  all  malignant 
tumors  is  unfavorable,  because  of  the  danger  of  recurrence 
and  the  difficulty  of  a  complete  removal.  Benign  tumors 
when  not  too  extensive  take  on  the  other  hand  a  favorable 
prognosis. 

Treatment.— Tumors  should  be  extirpated  early.  Under 
general  anesthesia,  and  strict  antiseptic  precautions,  they 
should  be  carefully  dissected  out,  including  some  of  the 
normal  tissue  to  be  sure  the  entire  growth  is  obtained.  A 
ligature  is  applied  firmly  around  the  base  of  them  to  con- 
trol the  hemorrhage,  when  they  may  be  removed  with  the 
scissors  or  knife.  Sometimes  it  is  advisable  to  cauterize  the 
base  of  the  tumor  with  a  thermocautery.  Other  methods  of 
procedure  in  the  removal  of  these  growths  will  depend  very 
largely  upon  the  location,  size  and  character  of  the  tumor. 

SUPPURATION  OF  THE  ANAL  GLANDS. 

This  condition  has  been  observed  quite  frequently  in  the 
dog.  The  anal  glands  secrete  a  grayish  or  brownish  material 
of  fetid  odor  and  acid  reaction,  discharged  through  a  circular 
Opening  on  either  side  of  the  margin  of  the  anus.  In  .old 
animals  the  secreting  membrane  often  becomes  inflamed  or 
irritated  from  constipation,  foreign  bodies,  infection,  etc., 
which  changes  the  character  of  the  secreted  material.  From 
infection,  the  secretion  becomes  purulent  and  the  orifice 
partially  or  completely  closed  giving  rise  to  a  retention  of 
the  secretion,  and  swelling.  In  some  cases  an  increase  of  the 
secretion  may  result  causing  discharge  which  collects  on  the 
margin  of  the  anus  or  soils  the  hair  around  the  anal  region. 
Sometimes  when  the  orifices  become  closed,  and  no  outlet 
is  left  for  the  escape  of  the  discharge,  the  skin  perforates 
over  the  enlargement  forming  an  exit  for  the  escape  of  the 


224  DISEASES  OF  THE  RECTUM  AND  ANUS 

discharge.  Thus  a  fistulous  tract  may  form.  Painful  defe- 
cation is  noted,  or,  if  the  pain  is  great,  severe  constipation 
results.  There  are  frequent  attempts  at  defecation,  and 
pruritis.  Direct  examination  reveals  the  presence  of  a  hot, 
sensitive,  fluctuating  enlargement  or  there  may  be  a  fistula 
present.  The  discharge  is  noted  when  it  collects  on  the  hair 
around  the  anus  and  tail  which  it  stains,  and  an  offensive 
odor  is  emitted. 

Diagnosis. — Usually  not  difficult  as  a  direct  examination 
will  reveal  the  condition. 

Treatment. — When  the  enlargement  is  present,  the  contents 
of  the  sac  should  be  expelled  by  pressure  with  the  thumb  and 
finger.  This  should  be  repeated  daily  for  several  days  in 
case  the  sac  shows  a  tendency  to  refill.  If  necessary  to  stop 
the  discharge,  Lugol's  solution  or  tincture  of  iodin  should  be 
injected  with  a  hypodermic  syringe,  enough  of  either  to 
slightly  distend  the  sacs.  This  treatment  can  be  repeated 
in  a  few  days  if  necessary. 

Should  a  fistulous  tract  be  found,  it  should  first  be 
thoroughly  cleansed  with  an  antiseptic  solution  (boric  acid 
2  per  cent.)  to  remove  all  of  the  secretions,  etc.,  then  injected 
with  Lugol's  solution  to  destroy  the  secreting  membrane. 

This  treatment  should  be  repeated  every  few  days  until  the 
discharge  ceases. 


CHAPTER  XII. 
DISEASES  OF  THE  LIVER. 

Examination.— The  liver  is  examined  by: 

(a)  Palpation.— This  method  is  not  very  satisfactory 
owing  to  the  well  protected  position  of  the  liver,  and  the 
thickness  of  the  abdominal  muscles  over  it.  However,  when 
the  liver  is  much  enlarged  from  acute  inflammation,  etc.,  it  is 
possible  to  palpate  it  through  the  walls. 

(6)  Laparotomy.— When  a  thorough  examination  of  the 
liver  is  desired  this  method  is  much  more  satisfactory  than 
by  palpation.  The  incision  is  made  just  posterior  to  the 
xiphoid  cartilage,  same  as  for  gastrotomy,  and  long  enough 
to  admit  of  a  thorough  examination.  The  liver  should  be 
examined  for  inflammations,  atrophy,  cirrhosis,  foreign 
bodies,  abscesses,  tumors,  injuries,  etc. 

ICTERUS.     JAUNDICE. 

Definition.— Icterus  (jaundice)  is  a  term  applied  to  staining 
of  the  tissues  with  bile  pigments.  It  is  characterized  clini- 
cally by  a  yellowish  or  greenish-yellow  discoloration  of  the 
skin,  mucous  membranes,  and  the  presence  of  the  bile  pig- 
ments in  the  urine.  This  is  not  a  disease  in  itself,  but  merely 
a  symptom  of  a  number  of  conditions,  indicative  of  a  disturb- 
ance in  the  secretion  or  excretion  of  bile,  which  is  significant 
of  a  disease  of  the  liver. 

Etiology.— Icterus  evidently  results  from  two  general 
conditions:  (a)  An  obstruction  at  some  point  in  the  course 
of  the  biliary  ducts  in  consequence  of  which  the  bile  becomes 
absorbed  by  the  lymphatics  or  the  bloodvessels,  producing 
icterus  by  stasis  or  hepatogenous  icterus.  This  form  of 
icterus  is  very  common  in  the  dog  and  has  a  number  of 
15 


226  DISEASES  OF  THE  LIVER 

etiological  factors,  which  are:  Catarrhal  inflammations  of 
the  mucous  membrane  of  the  stomach  and  duodenum,  the 
inflammation  being  sufficient  in  a  number  of  cases  to  close 
the  orifice  of  the  duct  by  the  swelling  of  the  mucosa;  foreign 
bodies  in  the  duct  producing  irritation  and  swelling;  parasites; 
gall-stones;  inflammatory  conditions  of  the  duct;  neoplastic 
formations  in  the  duct;  cicatricial  stenosis  of  the  duct; 
compression  of  the  duct  from  without  by  tumors  on  or  in  the 
stomach,  intestine,  lymph  glands  or  mesentery.  Adhesions 
after  operations  (gastrotomy),  fecal  accumulations,  aneu- 
rysms  of  the  arteries,  interference  with  the  outflow  of  bile  by 
torsion  of  the  ducts  which  sometimes  occurs  during  preg- 
nancy, tumors  in  the  abdomen,  etc.;  localized  inflammatory 
processes  in  the  liver  (abscesses),  and  primary  and  secondary 
new  growths  in  the  liver  are  further  etiological  factors. 
Obstruction  of  the  bile  ducts  causes  the  bile  to  be  retained 
in  the  liver,  the  hepatic  cells  continue  to  secrete  bile  and  to 
convert  into  bile  pigments  the  free  hemoglobin  brought 
thither.  From  the  resulting  accumulation  the  pressure  in  the 
smaller  biliary  capillaries  increases  causing  them  to  rupture 
into  the  lymph  spaces  to  be  eventually  carried  through  the 
lymph  vessels  to  the  general  circulation. 

(6)  Disturbance  in  the  function  of  the  liver  cells,  diverting 
the  bile  from  the  biliary  capillaries  to  the  lymphatics  or  blood- 
vessels producing  icterus  by  hemolysis  or  hemohepatogenous 
icterus.  This  form  of  icterus  occurs  most  commonly  from 
the  following:  In  many  infections,  such  as  the  different 
types  of  infectious  icterus;  distemper  (partly  obstructive, 
by  producing  a  catarrhal  inflammation  of  the  duodenum); 
pyemia;  in  the  different  forms  of  intoxications,  poisonings 
by  ptomaines,  mineral  poisons  (phosphorus,  arsenic,  coal-tar 
products,  etc.);  pernicious  anemia;  hemoglobinemia;  disturb- 
ance of  the  circulation,  such  as  passive  congestion;  some  nerv- 
ous diseases,  whereby  the  function  of  the  liver  is  modified. 

Pathology.— Yellow  discoloration  of  all  the  organs  and 
tissues  by  the  bile  pigment  with  the  exception  of  some  of  the 
nervous  and  corneal  tissue,  characterizes  the  postmortem. 
The  discoloration  varies  from  a  slight  tinge  of  yellow  to  a 
deep  greenish  yellow,  depending  upon  the  amount  of  bile 


ICTERUS— JAUNDICE  227 

pigment  deposited.  Catarrhal  inflammation  of  the  stomach 
and  duodenum  is  often  observed,  the  mucous  membrane 
swollen,  the  bloodvessels  congested,  and  as  a  rule  the  mouth 
of  the  hepatic  duct  will  be  found  closed  from  the  swelling  of 
the  mucosa.  The  duct  itself  is  often  found  occluded  from  a 
swelling  of  its  membranes  from  infection,  parasites,  foreign 
bodies,  gall-stones,  etc.  The  duct  is  usually  partially  filled 
with  a  thick,  syrupy,  or  semisolid  mass  of  bile  and  mucus. 
The  liver  is  usually  found  enlarged,  and  varies  in  color  from 
a  diffuse  light  yellow  to  yellowish-brown,  or  the  color  may  be 
irregularly  distributed  causing  a  mottled  appearance.  The 
boWtel  contents  are  light  gray  or  slate  gray  in  color,  owing  to 
the  absence  of  bile,  and  emit  a  fetid  odor. 

Symptoms. —The  early  manifestations  of  icterus  depend 
largely  upon  the  underlying  causes  of  which  jaundice  is 
merely  a  symptom.  All  of  the  tissues  and  organs,  with  the 
exception  of  the  nervous,  are  stained  with  biliary  pigments; 
in  very  severe  cases  where  infection  is  the  cause  the  nervous 
system  may  also  be  stained.  The  discoloration  is  most 
noticeable  in  the  skin  and  mucous  membrane. 

Mucous  Membranes  and  Skin.— Icterus  is  first  manifested 
by  a  yellowish  discoloration  of  the  eye  involving  the  con- 
junctiva and  sclera.  In  very  mild  cases  a  slight  tinge  of 
yellow  noticed  on  the  conjunctiva  may  be  the  only  symptom 
of  the  condition.  As  a  rule,  as  the  disease  progresses  the 
other  visible  mucous  membranes  will  also  show  the  yellowish 
discoloration.  In  the  dog  the  entire  membranes  of  the 
mouth  will  be  colored  yellow.  The  skin,  especially  if  non- 
pigmented,  becomes  a  characteristic  light  yellow,  or  greenish- 
yellow  depending  upon  the  amount  of  bile  pigment  distribut- 
ed. The  discoloration  is  seen  early  on  the  skin  of  the  abdo- 
men, thighs,  and  ultimately  over  the  entire  body.  In  dark 
skinned  animals  the  condition  can  also  be  observed,  the  skin 
assuming  a  dark  olive  green  color.  The  color  of  the  skin  may 
assist  somewhat  in  arriving  at  the  possible  etiological  factor, 
as  the  discoloration  is  usually  light  in  the  toxic  or  hemo- 
hepatogenous  icterus,  while  it  usually  is  darkest  when  the 
ducts  are  completely  obstructed— hepatogenous  icterus. 
The  intensity  of  the  external  symptoms,  therefore,  is  in  pro- 


228  DISEASES  OF  THE  LIVER 

portion  to  the  completeness  of  the  obstruction  to  the  ducts 
and  to  the  extent  of  the  rupturing  o*f  the  biliary  capillaries. 
The  symptoms  develop  on  the  external  membranes,  as  a  rule, 
in  a  few  hours,  although  in  some  cases  of  slow  development 
three  to  four  days  may  be  required  depending  upon  the  degree 
of  infection  or  obstruction  of  the  ducts. 

The  Urine.—  This  is  changed  in  color  to  a  yellowish-green, 
dark  green,  yellowish-red,  or  greenish-brown,  depending 
upon  the  amounts  of  bilirubin,  biliverdin  (oxidation  prod- 
ucts), or  urobilin  (reduction  product).  These  bile  pigments 
are  often  observed  in  the  urine  before  any  discoloration  takes 
place  in  the  tissues,  therefore  the  urine  furnishes  an  e&rly 
important  symptom.  The  urine  when  it  comes  in  contact 
with  organic  matter  will  stain  it  the  color  of  bile,  or  upon 
shaking  or  agitating  the  urine  it  will  form  a  foamy  liquid, 
which  is  quite  characteristic.  Gmelin's  test  may  also  be 
used  for  recognition  of  icteric  urine.  In  addition  to  the  bile 
pigments  the  urine  often  contains  a  number  of  hyaline  casts 
(indicating  nephritis)  and  desquamated  epithelial  cells. 

(>astro-intestinal  Tract. — The  absence  of  bile  from  the 
intestinal  tract  results  in  most  cases  in  the  passage  of  pale, 
grayish,  clay  colored,  or  slate  gray  feces,  having  a  fetid  odor, 
and  containing  undigested  fat,  and  hydrobilirubin.  The 
pale  color  is  due  partly  to  the  absence  of  bile,  and  partly  to 
the  imperfectly  digested  fat  which  may  be  increased  from  the 
normal  20  to  50  per  cent.  The  fetid  odor  of  the  feces  is 
ascribed  to  the  absence  of  bile  which  when  present  limits 
fermentation  of  the  intestinal  contents.  Constipation  is 
the  rule  in  the  majority  of  cases.  However,  diarrhea  may  be 
present  in  some  cases  due  to  the  imperfect  digestion  of  the 
fats  and  to  the  laxative  action  of  free  fatty  acids  which  are 
formed.  The  constipation  is  due  no  doubt,  when  present,  to 
defective  motility  of  the  muscular  walls  of  the  bowels,  from 
lack  of  the  normal  stimulating  properties  of  the  bile.  In- 
creased acidity  of  the  stomach  is  observed  in  many  cases,  the 
obstruction  to  the  flow  of  bile  apparently  causing  an  increase 
in  the  activity  of  the  gastric  secretion. 

Nervous  System.  —  Serious  nervous  symptoms  are  often 
observed.  The  bile  salts  present  in  the  circulation  are  at 


ICTERUS— JAUNDICE  229 

once  carried  to  the  nervous  system,  and,  when  accumulated 
in  sufficient  quantities,  will  produce  by  irritation  of  the  nerve 
cells  marked  symptoms  of  active  delirium,  convulsions,  etc. 
This  period  of  excitement  and  delirium,  as  a  rule,  lasts  only 
a  very  short  time,  terminating  in  depression,  muscular  de- 
bility, somnolence,  and  eventually  deep  coma  and  death  from 
a  general  paralysis. 

The  general  symptoms  (loss  of  appetite,  increased  thirst) 
are  noticeable  from  the  beginning.  Usually  a  subnormal 
temperature  (96-100°  F.)  exists,  depending  upon  the  severity 
of  the  condition.  Examination  of  the  liver  by  palpation  is 
unsatisfactory,  as  pain  or  enlargement  of  the  liver  is  rarely 
noted. 

Diagnosis  —The  recognition  of  this  condition  offers  no 
difficulties,  as  the  symptoms  are  very  characteristic.  How- 
ever, the  cause  in  many  cases  is  hard  to  determine.  In  dogs 
digestive  disturbances,  often  resulting  from  errors  in  diet, 
etc.,  produce  the  largest  percentage  of  cases.  Here  the 
anamnesis  is  valuable.  From  infectious  jaundice  a  differen- 
tiation can  in  most  cases  be  made  from  the  fact  that  this 
condition  occurs  mostly  in  young  dogs  (puppies)  and  in  an 
enzootic  form,  affecting  all  the  puppies  of  a  litter. 

Prognosis.— The  prognosis  in  icterus  is  generally  speaking 
unfavorable.  A  large  percentage  of  the  cases  in  the  dog 
terminate  fatally.  In  mild  cases,  due  to  catarrhal  inflamma- 
tion of  the  mucous  membrane  of  the  duodenum,  recovery 
usually  takes  place.  The  cause,  if  possible,  should  be  ascer- 
tained, and  the  conditions  thoroughly  considered  before 
making  a  prognosis. 

Treatment.—  Dietetic.— In  the  milder  cases  where  the 
appetite  is  retained  small  quantities  of  lean  meat  should  be 
given,  avoiding  all  fats  for  a  few  days.  In  severe  cases  to 
conserve  the  animal's  strength  eggs,  given  in  small  quantities 
of  milk,  are  useful.  During  convalescence  foods  should  be 
allowed  only  in  small  quantities,  avoiding  fats  and  irritating 
foods  as  much  as  possible. 

lied ical.— When  icterus  is  the  result  of  catarrhal  inflamma- 
tion of  the  duodenum,  it  is  advisable  to  irrigate  the  stomach 
with  bicarbonate  of  soda  solution  (2  per  cent.),  repeating  this 


230  DISEASES  OF  THE  LIVER 

operation  until  all  mucus  is  dissolved  and  the  liquid  flows 
out  clear.  This  treatment  should  be  used  at  least  once  or 
twice  daily.  Following  the  stomach  lavage  Carlsbad  salts 
(0.5-2.0)  are  useful  to  stimulate  secretions  and  to  dissolve  the 
mucus  accumulated  on  the  mucous  membrane  of  the  stomach 
and  duodenum.  In  some  cases  this  will  be  sufficient  to.  allow 
the  escape  of  the  bile  into  the  duodenum. 

Injections  of  warm  water  or  warm  bicarbonate  of  soda 
solution  (2  per  cent.)  into  the  rectum  as  high  up  as  possible 
are  often  valuable  to  stimulate  peristalsis,  encourage  defeca- 
tion, and  to  produce  alkalinity  of  the  intestinal  contents. 

Should  constipation  be  present  calomel  (dog,  0.3-0.4;  cat, 
0.1-0.15)  should  be  given  and  repeated  in  twelve  to  fifteen 
hours  if  catharsis  has  not  been  established.  Magnesium 
sulphate  (dog,  8.0-16.0;  cat,  1.0-4.0)  or  castor  oil  (dog, 
15.0-16.0;  cat,  5.0-20.0)  may  be  used  for  the  same  pur- 
pose. 

In  severe  cases  it  is  advisable  to  try  to  overcome  the 
obstruction  to  the  duct  and  empty  the  gall-bladder,  either  by 
mechanically  compressing  the  liver  by  manipulation  or  by  the 
use  of  emetics.  The  latter  method  has  proved  to  be  the 
most  satisfactory.  The  action  of  the  emetic  by  contracting 
the  abdominal  muscles  will  often  exert  enough  pressure  upon 
the  liver  and  gall-bladder  to  force  the  bile  out  into  the  bowel. 
An  obstruction,  such  as  mucus,  parasites,  foreign  bodies,  etc., 
can  thus  also  often  be  removed. 

When  the  bile  pigments  are  deposited  in  the  body  in  large 
quantities,  or  the  blood  contains  a  large  amount  of  unde- 
posited  bile  salts,  its  elimination  should  be  encouraged  by  the 
use  of  diuretics.  Potassium  acetate  or  nitrate  (dog,  0.20- 
0.50;  cat,  0.05-0.10)  is  to  be  given  twice  daily. 

General  stimulants,  such  as  camphor  or  ether,  are  indicated 
when  general  depression  and  coma  are  observed. 

In  severe  cases  normal  salt  solution  given  as  an  intravenous 
injection  is  useful  to  assist  in  the  elimination  of  bile  and  to 
produce  general  stimulation. 

Faradization  of  the  liver  has  been  tried  but  its  usefulness 
is  questionable. 


CONGESTION  OF  THE  LIVER  231 


CONGESTION  OF  THE  LIVER. 

Two  forms  of  this  disease  are  distinguished:  (a)  Active, 
and  (b)  passive. 

Active  Congestion.— Definition.— An  engorgement  of  the 
liver  with  blood  resulting  from  an  increased  circulation 
through  the  portal  vein  or  hepatic  artery. 

Etiology. —There  are  a  number  of  etiological  factors  in 
active  congestion  of  the  liver:  (a)  During  the  process  of 
digestion  there  is  a  physiological  increase  in  the  amount  of 
blood  carried  to  the  liver  by  the  portal  vein.  This,  however, 
usually  subsides  after  digestion  is  completed.  In  small 
animals,  owing  to  the  great  variation  in  the  amount  and 
quality  of  food  taken,  and  the  fact  that  the  food  often 
contains  irritating  material,  toxins,  ptomaines,  etc.,  all  of 
which  increase  the  functional  activity  of  the  liver,  a  more 
or  less  permanent  active  congestion  results.  (6)  Various 
poisons  provoke  a  severe  form  of  congestion  of  the  liver. 
These  include  many  autogenic  poisons  carried  to  the  liver 
from  the  intestinal  tract  by  the  portal  vein,  or  certain 
ptomaines  preformed  in  the  food  before  it  is  ingested.  Min- 
eral poisons  (arsenic,  mercury,  phosphorus)  can  produce  it. 
Some  of  the  toxic  products  of  infections,  which  develop  in 
the  intestinal  tract,  will  sometimes  be  carried  to  the  liver  in 
sufficient  quantities  to  excite  an  acute  congestion,  (c)  Con- 
gestion of  the  liver  may  also  result  from  the  specific  products 
of  certain  infections  (virus  of  distemper,  staphylococci  and 
streptococci)  that  may  reach  the  liver  via  the  general  circula- 
tion, (d)  Dogs,  when  kept  indoors,  fed  on  highly  nutritious 
food,  and  not  receiving  the  proper  amount  of  exercise,  will 
often  develop  active  congestion  of  the  liver. 

Many  of  the  causes  mentioned  are  also  the  chief  etiological 
factors  in  producing  inflammation  of  the  liver  (hepatitis) 
of  which  congestion  is  the  first  stage. 

Pathology.— The  liver  is  enlarged,  feels  firm  or  hard, 
contains  an  increased  amount  of  blood,  and  is  of  a  dark  red 
or  reddish-brown  color.  On  cut  surface,  the  blood  drips  or 
flows  off  freely. 


232  DISEASES  OF  THE  LIVER 

Symptoms.  -Due  to  the  fact  that  excretion  is  interfered 
with,  which  leads  to  a  general  intoxication  of  the  body, 
general  symptoms  of  stupidity,  depression,  loss  of  appetite, 
etc.,  appear.  Nausea  and  vomiting  are  often  observed. 
Constipation  is  the  rule.  The  feces  are  clay  colored  and  have 
a  fetid  odor.  Jaundice,  which  is  nearly  always  present,  is 
first  noticed  in  the  conjunctiva;  the  urine  is  stained  yellow 
with  bile  pigment.  The  liver  is  usually  enlarged  and  by 
palpation  it  may  be  distinguished  through  the  abdominal 
walls;  also  is  often  quite  painful  to  the  animal  when  com- 
pressed by  digital  pressure. 

The  urine  is  highly  colored  (often  green),  of  high  specific 
gravity,  and  shows  precipitates  of  urates  and  uric  acid.  The 
body  temperature  is  either  normal  or  subnormal. 

Diagnosis.— An  accurate  diagnosis  presents  some  difficul- 
ties. The  causes  (history),  the  disturbance  of  the  digestive 
tract,  the  jaundice,  and  the  enlarged  and  painful  liver,  should 
be  considered  in  arriving  at  a  definite  conclusion.  In  atypical 
cases  an  accurate  diagnosis  is  impossible,  although  enough 
symptoms  may  develop  to  suspect  the  acute  congestion. 

Prognosis.— The  prognosis  is  usually  favorable,  except  in 
those  cases  produced  by  poisons  and  infections.  In  these 
the  prognosis  will  depend  largely  upon  the  character  of  the 
infection  or  the  nature  and  amount  of  the  poison. 

Course.— In  most  cases  the  course  is  short,  rarely  lasting 
over  two  to  four  days. 

Treatment.— Dietetic.— All  irritating  food  should  be  with- 
held. The  diet  should  consist  almost  entirely  of  milk  given 
only  in  small  quantities  with  long  intervals  between  meals. 
Lime  water  added  to  the  milk,  to  make  it  alkaline,  will  have  a 
beneficial  action  on  the  mucosa  of  the  stomach  and  intestines. 

Medical.— Free  purgation  is  indicated  early.  Magnesium 
sulphate  (dog,  10.0-15.0;  cat,  1.0-5.0)  has  proved  to  be  the 
most  satisfactory.  These  doses  .should  be  repeated  until  free 
catharsis  has  been  established.  Calomel  may  also  be  used, 
but  is  not  as  good  as  magnesium  sulphate,  as  its  action  is 
more  cholagogic  which  would  be  contraindicated  where  con- 
gestion of  the  liver  exists.  When  nausea  and  vomiting  are 
present,  indicating  an  irritated  condition  of  the  stomach  and 


CONGESTION  OF  THE  LIVER  23!  5 

intestinal  muco.su,  sodium  bicarbonate  (dog,  0.5-1.0;  cat, 
0.2-0.8)  given  three  to  four  times  daily  is  beneficial.  Am- 
monium chlorid  (dog,  0.5-1.2;  cat,  0.2-0.5)  given  three  times 
daily  will  assist  in  the  excretion  of  the  urea,  uric  acid,  etc., 
and  relieve  the  intestinal  catarrh.  During  convalescence 
bitter  stomachics  are  indicated  to  stimulate  secretions  and  to 
assist  in  digestion.  Intestinal  antiseptics,  such  as  salol,  are 
also  often  indicated. 

Passive  Congestion.  Definition.— A  congestion  of  the  liver 
due  to  some  impediment  in  the  efferent  circulation  of  the 
blood  in  the  liver. 

Etiology. — This  condition  may  result  from  the  following: 
(a)  Defective  heart  action,  whether  it  be  acute  or  chronic, 
such  as  valvular  insufficiencies.  (6)  During  the  course  of 
some  diseases  of  the  lungs  which  increase  the  work  of  the 
right  side  of  the  heart,  eventually  weakening  it.  Examples 
are  emphysema,  chronic  bronchitis  (common  in  old  dogs), 
compression  by  pleural  exudates,  adhesive  pleuritis,  tumors  of 
the  mediastinum,  etc.  (c)  Local  obstructions  to  the  circula- 
tion of  blood  through  the  hepatic  veins  and  posterior  vena 
cava.  The  most  common  are:  Pleural  or  peritoneal  effu- 
sions (when  in  large  quantities,  displacing  the  heart  or  com- 
pressing the  veins),  tumors  of  the  liver  (carcinomas  and 
sarcomas  in  older  animals),  adhesions  around  the  liver  from 
abdominal  operations,  injuries,  etc. 

Pathology.— The  congested  liver  in  the  early  stages  is 
somewhat  increased  in  size,  depending  upon  the  amount  of 
blood  contained.  The  organ  is  firm,  dense  and  of  a  bluish 
or  dark  purple  color. 

Cut  section  shows  a  more  or  less  uniformly  congested, 
dark-blue  or  purplish  color,  and  presents  a  mottled  appear- 
ance with  light  areas.  In  the  advanced  stages  there  is  an 
excess  of  blood,  and  the  liver  presents  the  characteristics 
of  the  "nutmeg"  liver;  the  intralobular  and  sublobular 
venules  being  distended  and  filled  with  blood,  appearing  as 
dark  blue,  purplish  or  reddish  spots,  while  the  liver  cells  are 
pale  yellowish,  or  whitish,  showing  fatty  infiltration  and 
biliary  pigmentation,  which  gives  the  marked  contrast  in 
color  ("nutmeg"  liver).  In  the  most  advanced  stages,  the 


234  DISEASES  OF  THE  LIVER 

liver  becomes  smaller,  and  may  be  smaller  than  normal.  It 
is  firm  and  dense,  but  still  retains  the  characteristic  nutmeg 
appearance.  Connective  tissue  develops  around  the  central 
veins;  the  adjacent  hepatic  tissue  is  atrophic  and  pigmented, 
and  invading  it  are  fine  fibrous  connective  tissue  trabeculse. 
The  capsule  is  often  thickened  and  opaque. 

Symptoms.  —The  symptoms  vary  greatly,  depending  largely 
upon  the  causes.  When  due  to  primary  cardiac  or  pulmonary 
disease,  the  symptoms  are  complicated  with  these  condi- 
tions, those  of  the  primary  condition  usually  predominating. 
The  local  symptoms  are  principally  loss  of  appetite,  dis-. 
turbance  in  digestion,  nausea,  vomiting,  and  more  or  less 
obstinate  constipation.  Jaundice  is  a  common  symptom. 
It  may  be  moderate.  The  cyanosis  which  is  present  in  the 
conjunctiva  with  the  jaundice  produces  a  peculiar  bluish- 
green  color  of  the  mucous  membranes.  In  cases  where  infec- 
tion develops  rapidly,  the  jaundice  increases,  often  producing 
nervous  symptoms  such  as  excitement,  convulsions,  etc. 

Ascites  is  a  common  symptom  in  the  later  stages  resulting 
from  the  extensive  interference  with  the  circulation.  A  large 
amount  of  fluid  is  often  found  in  the  abdominal  cavity, 
especially  in  dogs.  In  the  early  stages  the  liver  is  enlarged, 
while  in  the  more  advanced  cases  it  may  be  atrophied. 
Examination  of  the  liver,  therefore,  by  palpation  may  not 
reveal  any  characteristic  condition.  An  accompanying 
gastro-intestinal  catarrh  develops  which  interferes  with 
digestion;  the  chronic  course  leads  to  general  weakness  and 
emaciation. 

Diagnosis.— The  diagnosis  depends  upon  finding  the 
primary  disease  of  the  heart  or  lungs,  the  condition  of  the 
liver,  and  the  local  symptoms'  of  icterus,  gastro-intestinal 
catarrh,  etc.  An  accurate  diagnosis  is  somewhat  difficult. 
A  careful  examination  of  the  patient  and  the  prolonged 
chronic  course  of  the  disease  will  assist  in  arriving  at  an 
accurate  conclusion. 

Prognosis.— As  a  rule  unfavorable,  especially  in  the  dog. 
It  depends  upon  the  primary  condition,  the  stage  of  the 
disease  and  the  condition  of  the  animal. 


HEPATITIS  235 

Treatment.—  Dietetic.— Treatment  affords  only  temporary 
relief.  Encourage  the  animal  to  eat,  by  giving  small  amounts 
of  lean  meat,  milk,  etc.,  which  may  be  given  in  conjunction 
with  alkalies  (sodium  bicarbonate)  to  conserve  the  strength. 

Medical.— For  defective  circulation,  due  to  diminished 
heart  action  (valvular  insufficiency),  digitalis  fluidextract 
(dog,  0.1-0.3;  cat,  0.025-0.05  once  or  twice  daily)  is  the 
most  efficient  drug,  especially  when  used  in  the  early  stages. 

Magnesium  sulphate  should  be  given  in  constipation. 
Stomachic  tonics  (gentian,  nux  vomica)  are  also  indicated. 

HEPATITIS. 

Definition.— An  acute  or  chronic  inflammation  of  the  liver. 
This  comprises  a  series  of  most  diverse  conditions  varying 
from  active  congestion,  acute  or  chronic  inflammation,  to 
localized  foci  of  necrosis  or  to  the  different  forms  of  icterus 
gravis. 

Etiology.— Hepatitis  may  result  from  the  many  causes 
enumerated  under  active  congestion  of  the  liver  (see  Conges- 
tion). The  only  real  difference  between  the  conditions  is  in 
degree.  A  clinical  differentiation,  therefore,  may  be  difficult. 
Acute  hepatitis  is  most  commonly  due  to  the  absorption  of 
toxins  during  the  course  of  infections  or  specific  infectious 
diseases.  It  may  also  result  from  the  absorption  of  toxic 
materials,  such  as  poisons,  from  the  intestinal  tract  (common 
in  dogs) . 

Chronic  interstitial  hepatitis  may  develop  from  the  acute 
or  from  valvular  disease  of  the  heart. 

Pathology.  — In  acute  hepatitis  the  pathological  changes  are 
varied.  The  whole  phenomena  of  inflammation  (congestion, 
cloudy  swelling,  focal  necrosis,  etc.)  may  be  present.  In 
mild  cases  the  liver  appears  as  in  active  congestion  with 
cloudy  swelling.  In  severe  cases  the  pathological  changes 
are  intensified.  The  liver  is  enlarged,  swollen,  softened,  and 
rather  pale  in  color;  the  cut  surface  is  pale,  opaque,  and 
shows  mottling  depending  upon  the  degree  of  inflammation. 

Symptoms.— The  symptoms  are  very  similar  in  many  res- 
pects to  those  of  active  congestion  of  the  liver  of  which  acute 


236  DISEASES  OF  THE  LIVER 

hepatitis  is  a  more  advanced  stage.  As  a  rule  the  symptoms 
are  more  intensive  than  in  acute  congestion.  Nausea  and 
vomiting  are  more  pronounced  and  usually  more  persistent; 
the  vomited  material  often  contains  a  quantity  of  bile  color- 
ing the  material  a  greenish  color.  Blood  may  be  vomited 
up  along  with  the  other  material,  from  the  irritation  of  the 
mucous  membrane.  Constipation  is  nearly  always  present. 
At  certain  periods  in  the  course  of  the  disease  diarrhea 
may  appear.  The  fecal  discharges  are  very  fetid,  yellowish 
or  clay  colored.  Icterus,  noticeable  on  the  conjunctiva, 
mucous  membrane  of  the  mouth,  and  sometimes  in  the  non- 
pigmented  skin,  will  be  a  prominent  symptom.  The  liver  is 
found  enlarged  and  sensitive  on  palpation. 

The  urine  is  usually  concentrated,  highly  colored,  of 
increased  specific  gravity,  and  contains  a  high  percentage 
of  urates  and  uric  acid  as  well  as  bile  pigment. 

The  temperature  in  the  early  stages  of  acute  hepatitis  is 
usually  quite  materially  elevated  (103-104°  F.).  The  fever 
temperature  assists  in  differentiating  the  condition  from 
simple  congestion.  However,  in  the  later  stages,  the  tem- 
perature may  be  found  normal,  or  even  subnormal,  due  to 
retained  toxins,  bile  salts,  etc.  The  general  symptoms  are 
dullness,  intense  thirst,  and  gastro-intestinal  disturbance. 

Diagnosis. — The  diagnosis  depends  on  the  causes,  the 
elevation  of  temperature,  the  enlargement  and  sensitiveness 
of  the  liver,  and  the  general  symptoms.  To  distinguish 
between  acute  congestion  and  inflammation  of  the  liver  is 
difficult  and  depends  upon  the  severity  of  the  symptoms. 

Prognosis. —The  prognosis  is  unfavorable.  In  some  of  the 
milder  cases  recovery  takes  place,  but  when  advanced  it 
nearly  always  proves  fatal. 

Treatment. —The  treatment  for  active  congestion  of  the 
liver  is  applicable.  (See  Active  Congestion  of  the  Liver.) 

In  chronic  hepatitis  treatment  is  valueless. 

Suppurative  Hepatitis.— Abscess  of  the  Liver.  —  Definition. 
—An  inflammation  of  the  liver  resulting  in  abscess  formation, 
which  occurs  under  a  variety  of  circumstances  and  in  several 
forms.  Liver  abscesses  are  commonly  divided  into  two  kinds : 
(a)  The  large  single  abscess;  (b)  the  small  multiple  abscess. 


HEPATITIS  237 

Fundamentally,  however,  the  two  kinds  may  not  differ  from 
each  other,  since  the  large  single  abscess  may  become  multiple 
by  infecting  adjacent  liver  tissue  giving  rise  to  the  develop- 
ment of  secondary  abscesses.  By  coalescence  a  number  of 
small  abscesses  may  by  peripheral  extension  form  a  large 
single  abscess. 

Etiology.— Liver  abscess  is  always  the  result  of  infection 
by  microorganisms  (staphylococci,  streptococci)  which  reach 
the  liver  in  one  of  several  ways:  (a)  Traumatism.  In 
small  animals  injuries,  direct  or  indirect,  frequently  give  rise 
to  abscess  of  the  liver.  Direct  injuries,  such  as  punctured 
wounds,  gunshot  wounds,  etc.,  permit  the  entrance  of 
pyogenic  organisms.  Indirectly  contusions  or  rupture  of 
the  liver,  which  reduce  the  resistance  to  infecting  organisms 
which  may  be  circulating  in  the  hepatic  or  portal  blood. 
Such  usually  produces  a  single,  small  or  medium-sized  abscess. 

(6)  Diseases  of  contiguous  organs  often  occasion  the  forma- 
tion of  abscess  in  the  liver.  Examples  are:  Gastric  or 
duodenal  ulcer  with  perforation;  abdominal  organs  which 
have  been  operated  and  infected,  and  suppurative  conditions 
of  adjacent  organs. 

(c)  Infection  via  the  portal  or  hepatic  circulation.  Multi- 
ple abscesses  result  from  gangrene  or  abscess  of  the  lungs, 
purulent  pleuritis,  purulent  and  fetid  bronchitis,  etc.  These 
processes  give  rise  to  many  infectious  einboli  which  lodge  in 
the  liver  forming  abscesses. 

(<7)  Infection  via  the  biliary  ducts.  Here  abscess  forma- 
tion is  due  to  the  infection  carried  in  through  the  bile  ducts, 
or  by  direct  extension  of  ulcerative  and  suppurative  processes 
in  the  biliary  tract  to  the  adjacent  liver  tissue. 

(c)  In  some  cases  infection  may  take  place  through  the 
lymphatics. 

Pathology.  Tin-  appearance  of  the  liver  will  vary  greatly, 
depending  upon  the  mode  of  infection,  the  virulence  of  the 
infecting  material,  and  the  location  and  number  of  abscesses. 

Abscesses  resulting  from  traumatism,  ulcerative  and 
suppurative  processes  in  adjacent  organs  are  usually  single, 
small  or  of  moderate  size,  and  mostly  superficial.  These 
abscesses  are  in  isolated  areas,  a  focus  of  inflammation  sur- 


238  DISEASES  OF  THE  LIVER 

rounded  by  a  zone  of  intense  hyperemia.  In  or  near  the 
center  liquefaction  necrosis  of  the  exudation  begins  which 
spreads  by  peripheral  extension  until  a  smaller  or  larger 
area  of  softened  or  fluid  purulent  material,  surrounded  by 
a  more  or  less  well  defined  zone  of  limitation,  results.  The 
softened  material  consists  of  leukocytes,  red  cells,  necrotic 
and  degenerated  liver  tissue,  infection,  etc.  The  abscesses 
are  very  commonly  situated  near  or  on  the  surface  of  the 
liver.  The  surface  of  the  liver  is,  therefore,  involved  (peri- 
hepatitis),  and  extensive  adhesions  may  bind  to  it  the 
contiguous  organs.  In  some  cases  (especially  after  opera- 
tions) the  abscess  is  on  rather  than  in  the  liver  (suprahepatic, 
infrahepatic) . 

When  small,  multiple,  metastatic  abscesses  are  present,  the 
liver  is  usually  enlarged,  swollen,  opaque,  and  shows  evidence 
of  parenchymatous  degeneration,  or  cloudy  swelling.  On 
section  the  organ  reveals  numerous  grayish  or  yellowish, 
softened  spots  surrounded  by  hyperemic  zones;  the  spots 
vary  considerably  in  size  depending  upon  the  stage  of  develop- 
ment of  the  condition.  In  some  cases  the  numerous  small 
abscesses,  by  peripheral  extension,  become  confluent  and 
form  a  large  abscess  which  may  involve  a  whole  lobe  or  in 
some  cases  the  entire  liver.  The  purulent  contents  are 
usually  thick,  creamy,  yellowish,  or  thinner  and  seropurulent, 
or  stained  with  blood  or  bile;  the  surrounding  liver  tissue  is 
in  most  cases  stained  a  greenish-yellow  tint.  The  pus  often 
has  an  offensive  odor  especially  when  due  to  gastric  or  duo- 
denal ulcers. 

Symptoms.— The  early  manifestations  are  not  very  charac- 
teristic. Therefore,  unless  the  condition  is  well  established 
involving  a  large  portion  of  the  liver,  or  interfering  severely 
with  its  function,  it  is  apt  to  be  overlooked. 

In  traumatic  abscess,  and  abscesses  due  to  spread  of 
infection  from  adjacent  organs,  the  patient  usually  shows 
pain  in  the  region  of  the  liver,  especially  when  the  animal  is 
handled  or  moved  about.  Jaundice,  due  to  compression  of 
the  biliary  ducts,  and  enlargement  of  the  liver  can  usually 
be  determined  by  palpation;  fluctuation  may  also  be  evident. 
In  multiple  abscess  the  diagnosis  is  difficult,, as  there  are 


HEPATITIS  239 

no  characteristic  symptoms.  The  temperature  is  variable, 
usually  slightly  elevated;  chills  may 'be  present.  Examina- 
tion of  the  blood  often  reveals  leukocytosis,  which  is  not 
always  present,  especially  in  chronic,  well  encapsulated 
abscesses.  The  urine  is  concentrated,  highly  colored,  specific 
gravity  increased,  with  an  abundant  deposit  of  urates  and 
uric  acid.  When  there  is  much  destruction  of  the  liver  tissue 
the  amount  of  urea  is  diminished,  and  albumin  is  often 
present. 

Spontaneous  rupture  of  the  abscesses  often  takes  place, 
especially  in  those  cases  resulting  from  traumatism,  causing 
serious  symptoms  to  suddenly  develop.  As  in  most  cases 
the  rupture  occurs  into  the  peritoneal  cavity,  a  generalized 
peritonitis  follows  which  soon  leads  to  death. 

Diagnosis.— An  accurate  diagnosis  is  usually  quite  difficult. 
The  most  suggestive  signs  are  progressive  enlargement  and 
tenderness  of  the  liver,  jaundice,  chills  and  fever,  leukocytosis, 
and  the  consideration  of  the  etiological  factors. 

When  an  abscess  is  suspected  an  accurate  diagnosis  can 
be  made  with  safety  (especially  in  the  dog)  by  making  an 
explorative  laparotomy. 

Prognosis.— Abscesses  of  the  liver  even  in  the  single  supra- 
hepatic  form  should  always  be  considered  unfavorable. 
The  small  multiple  abscesses  are  almost  always  fatal,  death 
occurring  in  one  to  two  weeks. 

Treatment.— The  early  indications  in  the  treatment  are 
surgical.  Under  general  anesthesia  and  strict  antiseptic- 
precautions,  an  explorative  laparotomy  should  be  per- 
formed. The  incision  in  the  abdominal  wall  should  be 
made  large  enough  to  admit  of  a  careful  and  free  examination 
of  the  liver.  Should  the  abscess  be  suprahepatic,  or  single 
in  the  liver  substance,  that  portion  of  the  liver  is  carefully 
brought  out  through  the  incision.  It  is  very  important  that 
the  liver  be  carefully  manipulated  to  prevent  rupturing  the 
abscess.  Should  the  abscess  be  of  large  size,  it  is  often 
advisable  to  aspirate  most  of  the  contents  before  it  is  manipu- 
lated to  prevent  rupture  of  the  sac  and  also  to  facilitate 
its  withdrawal  through  the  abdominal  incision.  \Vhen  the 
affected  portion  of  the  liver  is  withdrawn,  it  should  be  sur- 


240  DISEASES  OF  THE  LIVER 

4 

rounded  on  either  side  with  sterile  gauze  to  prevent  any  of 
the  pus  entering  the  cavity  while  operating.  A  free  incision 
is  made  directly  over  the  abscess  its  full  length,  the  contents 
of  the  cavity  thoroughly  washed  out  with  boric  acid  solution 
(2  per  cent.)  and  the  abscess  wall  thoroughly  curetted  to 
remove  all  of  the  necrotic  tissue  and  detritus.  If  necessary 
some  of  the  tissue  is  removed  with  the  scissors  or  knife  to 
straighten  the  edges  of  the  wound,  and  also  to  be  sure  to 
remove  all  of  the  necrotic  tissue.  The  wound  in  the  liver  is 
sutured  with  a  deep  continuous  suture.  Should  the  hemor- 
rhage interfere  it  should  be  controlled  by  ligating  the  larger 
vessels. 

Should  the  abscess  be  suprahepatic  or  infrahepatic,  the 
affected  parts  should  be  carefully  withdrawn,  the  adhesions 
broken  down  and  the  entire  wall  of  the  abscess  completely 
extirpated.  All  exposed  portions  should  be  thoroughly 
irrigated  before  returning  to  the  abdominal  cavity. 

When  multiple  abscesses  are  found  surgical  treatment  is 
rarely  of  value.  The  external  wound  is  sutured  as  in  gastrot- 
omy.  (See  Gastrotomy.) 

ATROPHY  OF  THE  LIVER. 

Definition.— A  term  generally  applied  to  a  reduction  in  the 
size  of  the  liver.  In  most  conditions  where  there  is  a  reduc- 
tion in  the  size  of  the  liver  it  is  due  to  degenerative  changes. 

Etiology.— Atrophy  of  the  liver  occurs  most  commonly 
from  the  following: 

(a)  Pressure  upon  the  liver,  by  tumors,  enlargement  of 
adjacent  organs,  passive  congestion,  amyloid  disease,  etc. 
These  causes  may  produce  a  true  atrophic  condition  of  the 
liver  with  subsequent  replacement  fibrosis,  or  atrophy  and 
degeneration  (fatty  degeneration  and  necrosis)  as  in  passive 
congestion  and  amyloid  disease. 

(b)  From  a  stenosis  or  occlusion  of  the  portal  vein,  general 
hepatitis,    advanced    passive    congestion,    etc.,    a    general 
atrophy  of  the  liver  may  develop. 

(c)  A  reduction  in  the  size  of  the  liver,  which  is  not  a  true 
atrophic   condition,   follows   many   degenerative   processes, 


FATTY  LIVER  241 

such  as  poisoning  by  phosphorus,  arsenic,  mercury,  chloro- 
form, etc. 

(d)  Reduction  in  the  size  of  the  liver  frequently  occurs,  to 
which  the  term  atrophy  is  applicable,  in  inanition,  cachexia, 
etc.  In  this  case  the  liver  participates  in  the  general 
atrophic  process. 

Pathology.— The  liver  is  smaller  than  normal,  dark  in  color, 
dense,  of  increased  specific  gravity,  and  dry.  These  changes 
are  the  result  of  the  increase  in  the  connective  tissue  and  the 
decrease  in  the  parenchyma.  On  cut  section  the  surface  is 
dry,  and  the  liver  substance  very  dense  and  firm. 

Symptoms.—  The  symptoms  are  not  very  characteristic. 
There  will  be  noticed  inanition,  cachexia,  etc.  The  patient 
shows  digestive  disturbances,  and  the  feces  are  light  colored. 
The  liver  is  very  small ;  owing  to  its  location  it  is  difficult  to 
palpate. 

Diagnosis.— An  accurate  diagnosis  is  in  most  cases  impos- 
sible during  the  life  of  the  animal.  The  etiological  factors 
may  assist  somewhat  in  making  a  diagnosis. 

Prognosis.— The  prognosis  should  always  be  considered 
unfavorable,  owing  to  the  structural  change  which  has  taken 
place  in  the  liver,  and  the  difficulty  of  removing  the  causative 
factors. 

Treatment.— Satisfactory  treatment  is  hardly  possible, 
although  treatment  for  the  removal  of  the  cause  would  be 
indicated. 

FATTY  LIVER. 

Definition.— A  term  applied  to  the  excessive  amount  of  fat' 
in  the  liver.  It  includes  fatty  infiltration,  in  which  there  is 
an  excessive  deposit  of  fat  without  the  liver  cells  becoming 
much  altered,  and  also  fatty  degeneration,  in  which  the  liver 
cells  are  converted  into  fat  cells. 

Etiology.— The  causes  are:  (a)  Feeding  of  animal  for  a 
long  period  on  fats  and  carbohydrates,  without  the  proper 
amount  of  exercise.  This  tends  to  produce  obesity  (which 
is  common  in  house  dogs),  of  which  fatty  liver  is  a  common 
symptom.  The  fatty  deposit  is  probably  due  to  the  incom- 
plete oxidation  of  the  excessive  amounts  of  food.  (6)  Anemia, 
16 


242  DISEASES  OF  THE  LIVER 

and  cachexia,  occurring  in  the  later  stages  of  chronic  diseases, 
carcinomatosis  and  sarcomatosis,  general  inanition,  etc. 
These  conditions  result  in  an  insufficient  supply  of  blood, 
therefore  incomplete  oxidation,  (c)  Passive  congestion  of 
the  liver  due  to  valvular  insufficiency  of  the  heart,  (d) 
Poisonings,  such  as  phosphorus,  arsenic,  mercury,  etc.,  which 
are  very  common  in  small  animals.  Ptomaines  from  meats 
will  produce  a  similar  effect,  (e)  Infections  developing 
in  the  intestinal  tract,  as  distemper,  infectious  diarrheas, 
etc.,  the  toxins  of  which  are  carried  to  the  liver  through  the 
portal  vein.  General  infection,  such  as  by  pyogenic  organ- 
isms, will  produce  the  same  effect  on  the  liver. 

It  is  quite  evident  that  the  majority  of  cases  of  fatty  liver 
develop  through  a  deficient  oxidation. 

Pathology.— The  liver  is  enlarged,  often  twice  the  normal 
size,  the  specific  gravity  lessened,  and  the  resistance  reduced. 
It  is  pale  yellow  in  color,  or  yellowish  areas  or  streaks  are 
seen  on  the  surface.  The  surface  is  smooth,  and  the  edges 
somewhat  rounded.  On  cross-section  it  is  usually  pale, 
anemic,  and  fat  globules  which  adhere  to  the  knife  are  often 
noted.  In  cases  of  passive  congestion  the  characteristic 
appearance  of  nutmeg  liver  is  observed  (dark  center  and 
light  periphery  of  the  lobules). 

Symptoms.— The  symptoms  of  fatty  liver  are  very  obscure, 
and  not  sufficient  in  most  cases  to  make  an  accurate  diagnosis 
intra  mtam. 

AMYLOID  LIVER. 

Definition.— A  degenerative  process  of  the  liver  charac- 
terized by  the  conversion  of  the  proteins  of  the  tissues  into 
a  structureless,  homogeneous  substance  called  lardacein. 

Etiology. — This  condition  results  most  commonly  in  animals 
from  the  absorption  of  the  toxins  of  pyogenic  organisms.  It 
requires  for  its  production  a  long  time  and  a  persistent  and 
continuous  infection.  It  is  not  a  very  common  condition  in 
animals,  and  usually  accompanies  a  general  amyloid  degen- 
eration of  other  organs. 

Pathology.— The  liver  is  enlarged,  sometimes  two  or  three 
times  its  normal  size,  and  the  edges  are  rounded  or  blunt. 


CIRRHOSIS  OF  THE  LIVER  243 

The  color  is  grayish-brown,  and  on  cut  section  shows  white 
points.  Microscopic  examination  reveals  the  amyloid  degen- 
eration. 

Symptoms.— Difficult  to  recognize  during  the  life  of  the 
animal,  and  is  only  of  importance  to  the  pathologist.  Other 
degenerative  conditions. which  have  been  observed  on  post- 
mortem in  small  animals  are  only  of  importance  to  the  student 
in  pathology  and  will  not  be  described  here,  as  a  diagnosis 
can  only  be  made  on  postmortem. 

CIRRHOSIS  OF  THE  LIVER. 

Chronic  Interstitial  Hepatitis. 

Definition.— A  chronic  inflammation  of  the  liver  with  an 
increase  in  the  interstitial  connective  tissue. 

Etiology. — The  exact  causes  are  not  definitely  known. 
Infection  no  doubt  plays  an  important  role,  bacterial  toxins 
from  the  intestinal  tract  being  carried  direct  to  the  liver. 
It  may  be  produced  secondarily  from  other  diseases  of  the 
liver,  such  as  acute  and  chronic  hepatitis,  congestion,  etc. 
Parasitic  invasion  has  been  known  to  produce  it  in  certain 
districts. 

Pathology.— In  the  early  stages  the  organ  is  usually  en- 
larged; in  later  stages  often  atrophic.  The  liver  maintains 
its  shape,  the  surface  is  smooth,  or  in  some  cases  granular. 
The  color  varies  somewhat  from  a  light  green  to  a  dark  olive 
green,  and  the  liver  nodules  are  separated  by  connective 
tissue.  The  consistency  of  the  liver  is  greatly  increased,  and 
when  incised  it  cuts  hard  and  grates  under  the  knife,  due  to 
the  excessive  amount  of  connective  tissue.  The  bile  passages 
are  usually  found  normal. 

Symptoms.— The  symptoms  are  those  of  a  chronic  condi- 
tion, with  which  is  associated  a  disturbance  in  the  intestinal 
tract.  Jaundice,  which  is  usually  mild,  producing  only  a 
slight  tinge  of  yellow  in  the  mucous  membranes;  bile  in  the 
urine,  giving  it  a  greenish  color;  nausea  and  vomiting  are 
often  observed  in  the  dog.  An  enlargement  of  the  liver  can 
be  readily  detected  by  palpation.  In  the  advanced  stages  of 


244  DISEASES  OF  THE  LIVER 

the  disease  there  is  often  ascites,  enlargement  of  the  spleen, 
and  eventually  general  cachexia. 

Diagnosis.— In  animals  a  diagnosis  is  very  difficult.  The 
condition  is  usually  first  noted  on  postmortem  examination. 
An  explorative  laparotomy  in  the  dog  is  recommendable. 

Prognosis.— The  prognosis  is  unfavorable  owing  to  the 
changes  which  have  developed  in  the  structure  of  the  liver. 

Treatment.—  Dietetic.— Small  quantities  of  easily  digested 
food  (raw,  lean  meat,  milk,  etc.)  should  be  given  to  sustain 
the  condition  of  the  animal. 

Medical.— Salines  (magnesium  sulphate,  dog  8.0-12.0)  are 
indicated  to  produce  a  laxative  action. 

Should  ascites  be  present  diuretics  are  indicated  to  assist 
in  the  removal  of  the  fluid  from  the  abdominal  cavity. 

Surgical. — Thoracentesis  abdominis  is  indicated.  (See 
Ascites.) 

NEOPLASMS  OF  THE  LIVER. 

Tumors  of  the  liver  are  not  very  common,  except  second- 
ary to  malignant  growths  in  other  organs.  These  consist 
mainly  of  carcinomas  and  sarcomas,  which  have  become 
generalized  (carcinomatosis  and  sarcomatosis) .  Benign 
tumors  are  occasionally  met  with,  viz.:  Adenomas  and 
angiomas. 

Symptoms. — Tumors  of  the  liver  are  difficult  to  recognize 
during  life,  and  only  in  those  cases  where  they  become  very 
large,  producing  distention  of  the  abdomen,  will  they  be 
recognizable.  Palpation,  when  done  carefully,  will  often 
reveal  the  tumor  which  will  be  freely  movable  in  the  cavity. 
If  the  tumor  is  malignant  (sarcoma  and  carcinoma)  it  will 
lead  to  symptoms  of  anemia  and  cachexia.  An  accurate 
diagnosis  can  only  be  made  after  laparotomy. 

Treatment.— When  malignant  tumors  are  found,  no  treat- 
ment is  of  value.  Benign  tumors  may  be  removed  by 
carefully  ligating  all  vessels,  and  preferably  removing  an 
entire  lobe  of  the  liver  where  affected.  Hemorrhage  is 
usually  severe  when  the  tissue  of  the  liver  is  incised.  There- 
fore operations  on  the  liver  are  always  considered  serious. 


CHOLELITHIASIS— GALL-STONES  245 

CHOLELITHIASIS.     GALL-STONES. 

Cholelithiasis  is  quite  rare  in  animals.  Only  a  few  cases 
have  been  reported  where  free  concretions  were  found  in 
the  biliary  ducts  and  these  occurred  most  commonly  in  the 
gall-bladder  and  ductus  choledochus.  Gall-stones  are  the 
result  of  a  catarrhal  inflammation  of  the  membrane  of  the 
duct  or  gall-bladder  causing  a  desquamation  of  the  epithe- 
lium and  a  collection  of  bile  salts,  gradually  forming  con- 
cretions. Infection  or  parasites  gaining  entrance  via  the 
duct  and  producing  irritation  are  common  causes. 

Symptoms.— Gall-stones  may  exist  for  some  time  without 
producing  any  marked  symptoms,  depending  upon  the 
location  of  the  concretion.  When  in  the  gall-bladder  but 
little  disturbance  will  be  produced,  but  when  the  concretion 
passes  out  into  the  ductus  choledochus,  severe  colicky  symp- 
toms are  observed,  and  by  completely  blocking  the  exit  of 
the  bile,  obstruction  or  hepatogenous  icterus  is  produced. 
(See  Icterus  or  Jaundice.)  A  diagnosis  is  difficul:  and,  when 
suspected,  an  explorative  laparotomy  should  be  performed. 

Treatment.— Surgical  means  should  be  employed  early. 
Under  general  anesthesia  laparotomy  is  performed,  as  for 
gastrotomy  (see  Gastrotomy)  making  the  incision  longer,  if 
necessary.  The  portion  of  the  liver  containing  the  gall- 
bladder and  duct  is  brought  out  through  the  incision.  A 
careful  examination  should  be  made  to  determine  the  location 
of  the  concretion.  When  located,  an  incision  is  made  down 
upon  the  concretion  just  large  enough  for  its  removal.  Care 
should  be  taken  to  prevent  the  bile  from  running  into  the 
cavity.  After  all  the  concretions  are  removed  the  wound 
is  stitched  carefully  with  a  fine  suture  using  a  small,  straight 
needle.  A  continuous  suture  is  first  used  to  bring  the  edges 
of  the  wound  in  apposition,  and  then  a  Lembert  suture 
to  completely  close  the  opening  and  to  bring  the  serous 
membranes  together  for  rapid  healing.  The  parts  should 
be  thoroughly  cleansed  before  returning  to  the  abdominal 
cavity.  The  laparotomy  wound  is  sutured  in  the  regular 
manner.  (See  Laparotomy.) 


246  DISEASES  OF  THE  LIVER 

RUPTURE  OF  THE  LIVER. 

i 

Ruptura  Hepatw.     Apoplexia  Hepatis. 

Etiology. — Owing  to  the  structure  of  the  liver  being  very 
friable  and  easily  torn  and  its  blood  supply  great,  it  is  not 
uncommon  that  rupture  of  this  organ  takes  place.  The 
common  causes  are  injuries,  such  as  being  run  over  by 
vehicles,  penetrating  rib  fractures;  severe  exertion  (running, 
jumping,  falling,  etc.),  or  during  the  course  of  infectious  dis- 
eases when  there  is  a  severe  congestion  or  inflammation  of 
the  liver.  Predisposing  factors  are:  Degenerative  processes 
in  the  liver,  such  as  fatty  liver,  amyloid  liver,  etc.,  or  diseases 
of  the  heart  and  vessels. 

Pathology.— The  postmortem  lesions  depend  largely  upon 
the  extent  of  the  rupture.  Small  hemorrhages  are  often 
found  showing  through  the  capsule  of  the  liver,  greater  may 
occur  in  the  form  of  a  large  hematoma.  In  most  cases,  how- 
ever, the  capsule  also  becomes  torn  and  the  blood  is  allowed 
to  flow  out  into  the  abdominal  cavity.  The  liver  when 
examined  will  reveal  the  rupture.  The  other  tissues  and 
organs  will  be  pale  and  anemic. 

Symptoms.  — Small  hemorrhages  in  the  liver  will  not  pro- 
duce any  marked  symptoms.  If  severe  there  will  be  all  the 
symptoms  of  internal  hemorrhage,  such  as  paleness  of  the 
mucous  membranes,  general  weakness,  anxious  expression, 
weak  rapid  pulse,  and  dyspnea;  the  extremities  and  skin 
become  cold,  trembling  of  muscles,  and  finally  coma.  Death 
often  takes  place  very  suddenly  or  within  ten  or  twelve  hours, 
depending  upon  the  extent  of  the  rupture.  Small  and  con- 
tinuous hemorrhages  will  be  observed  where  the  rupture  is 
very  small  or  where  a  hematoma  is  forming  showing  symp- 
toms of  weakness,  paleness  of  the  membranes  and  often  some 
icteric  symptoms.  Such  cases  often  recover  in  a  few  days  or 
death  may  occur  from  exhaustion  in  four  to  ten  days. 

Diagnosis.  — An  accurate  diagnosis  is  very  difficult.  The 
anamnesis  may  assist  in  arriving  at  a  definite  conclusion. 

Prognosis.  — Should  be  considered  unfavorable  as  most 
cases,  especially  where  the  hemorrhage  is  severe,  terminate 


RUPTURE  OF  THE  LIVER  247 

fatally.  Where  slight  hemorrhage  takes  place,  the  prognosis 
is  more  favorable,  although  if  there  is  some  disease  of  the 
liver  present,  fatal  hemorrhage  may  recur  at  any  time. 

Treatment.— The  treatment  must  be  given  as  early  as 
possible  and  is  the  same  as  for  any  internal  hemorrhage. 

Subcutaneous  injections  of  ergotin  (dog,  0.1-0.3)  or  adrena- 
lin chlorid  (0.5  to  1.0  of  a  1-1000  solution)  are  useful.  These 
doses  can  be  repeated  in  a  half  to  one  hour  if  necessary. 

To  stimulate  the  heart  action  strychnin  sulphate  (0.001) 
or  caffein  citrate  (0.1-0.3)  should  be  given  every  few  hours. 
Otherwise  the  treatment  is  symptomatic. 


CjHAPTER  XIII. 
DISEASES  OF  THE  PERITONEUM. 

General  Remarks. — The  peritoneum  is  a  serous  sac,  and, 
considering  all  of  its  reflections  and  fossae,  it  covers  a  surface 
very  nearly  as  great  as  that  of  the  skin.  In  the  female  it 
differs  from  other  serous  cavities  in  that  it  has  an  indirect 
external  opening  through  the  uterine  tube;  in  the  male  there 
is  no  opening. 

The  peritoneum  through  the  lymphatics  and  bloodvessels 
has  great  power  of  absorption  as  has  been  demonstrated  on 
numerous  occasions.  The  dog  or  rabbit  will  absorb  fluid 
equal  to  10  per  cent,  of  the  body  weight  in  a  half  hour. 
Fluids  and  soluble  substances  are  readily  taken  up  and  car- 
ried away  by  the  blood,  while  insoluble  substances,  including 
microorganisms,  are  taken  up  by  the  lymphatics  with  the 
aid  of  the  phagocytes.  In  health,  the  secretion  of  fluid  into 
the  peritoneal  cavity  and  the  absorption  therefrom  is  just 
sufficient  to  keep  the  surfaces  moist  and  free  from  infection. 
In  disease  this  normal  equilibrium  becomes  disturbed,  and 
either  produces  a  dry  condition  of  the  membrane,  from 
absorption  being  greater  than  secretion  (acute  inflammation), 
or  secretion  being  in  excess  of  absorption  (ascites).  The 
presence  of  the  fluid  in  the  peritoneal  sac  has  a  further  action 
than  preventing  friction  to  the  surface,  and  that  is  by  exert- 
ing a  bactericidal  action. 

The  lymphatic  absorption  is  carried  forward  by  the 
lymphatic  trunks  to  the  mediastinal  glands.  Experiments 
have  shown  that  microorganisms  can  be  removed  from  the 
peritoneal  sac  via  the  lymph  stream,  and  carried  into  the 
mediastinal  glands  in  six  minutes  after  their  injection  into 
the  abdominal  cavity.  The  peritoneum  covering  the  dia- 
phragm and  the  omentum  is  most  active  in  this  process  of 


GENERAL  REMARKS  249 

absorption,  removing  inert  bodies  and  also  microorganisms 
from  the  peritoneal  cavity.  The  omentum  is,  further,  an 
important  factor  in  preventing  peritonitis,  in  that  it  removes 
the  microorganisms  from  the  abdominal  cavity  before  they 
can  produce  their  pathogenic  action.  The  omentum  also 
has  the  great  faculty  of  localizing  inflammation  and  infection 
by  attaching  itself  to  any  inflamed  organ  or  possible  source 
of  infection.  It  becomes  fixed  around  the  margin  of  the 
inflammatory  or  infected  area,  where  it  adheres,  preventing 
generalization.  The  omentum  is  an  important  protective 
mechanism  after  surgical  work  on  the  organs  in  the  abdominal 
cavity.  Another  point  worthy  of  mention  is  the  fact  that 
abscesses  which  develop  following  operations,  puncture  of 
abdominal  walls,  etc.,  usually  open  to  the  outside  rather  than 
in  the  abdominal  cavity,  due  no  doubt  to  the  great  defensive 
powers  of  the  peritoneum  as  compared  to  the  other  tissues. 

The  visceral  peritoneum  is  not  very  sensitive  to  pain  while 
the  parietal  is  very  sensitive.  Therefore,  the  reason  for 
extreme  sensitiveness  to  pressure  over  the  abdomen  in  acute 
peritonitis.  The  visceral  peritoneum  even  in  inflammatory 
conditions  is  not  very  sensitive.  The  natural  resistance  of 
the  peritoneum  varies  greatly  in  the  different  animals.  The 
dog  seemingly  has  the  greatest  resistance,  and,  therefore, 
abdominal  surgery  can  be  practised  on  this  animal  with  a 
much  greater  degree  of  safety  than  in  other  animals.  The 
cat  is  slightly  less  resistant  than  the  dog.  However,  it  must 
always  be  remembered  that  there  is  a  great  variation  in  the 
natural  resistance  of  individuals  of  the  same  species  depend- 
ing to  a  great  extent  upon  their  physical  condition,  etc. 

As  a  summary,  the  defensive  powers  of  the  peritoneum 
are  of  great  importance  and  are:  (a)  Its  great  absorbing 
power,  removing  organisms  before  they  can  multiply  suffi- 
ciently, produce  toxins,  and  excite  inflammation,  (b)  The 
phagocytic  action  exerted  by  leukocytes,  polymorphonuclear 
leukocytes  and  the  endothelial  cells,  (c)  The  faculty  of  the 
omentum  in  walling  off  local  infections  and  inflammations 
preventing  diffuse  peritonitis,  (rf)  The  antitoxic  and 
bactericidal  properties  of  the  peritoneal  fluid.  Thi-  thud 
is  increased  when  necessary. 


250  DISEASES  OF  THE  PERITONEUM 

PERITONITIS. 

Definition.— An  inflammation  of  the  peritoneum.  From 
the  standpoints  of  intensity  and  duration  peritonitis  may  be 
classified  into:  (a)  Acute,  and  (6)  chronic. 

.Acute  Peritonitis.— Definition.— An  acute  inflammation  of 
the  peritoneum.  From  a  clinical  standpoint  acute  perito- 
nitis may  be  divided  into:  (a)  Circumscribed  or  localized, 
and  (6)  general  or  diffuse.  Other  divisions  are  hardly  recog- 
nizable during  the  life  of  the  animal.  Even  the  most  severe 
cases  of  peritoneal  infection  often  show  the  least  evidence 
of  inflammatory  reaction.  The  inflammatory  reaction  which 
takes  place  in  peritonitis  is  often  a  salutary  process,  by  pre- 
venting excessive  absorption  from  the  peritoneum,  leading  to 
the  destruction  of  microorganisms  that  have  gained  entrance, 
and  by  the  formation  of  fibrin  and  adhesions  preventing  the 
spread  of  infection  to  the  entire  serous  membrane. 

Etiology.— From  the  standpoint  of  cause  acute  peritonitis 
may  be  divided  into :  (a)  Primary,  and  (6)  secondary. 

(a)  Primary,  acute  peritonitis  is  applied  to  those  cases 
where  there  is  no  local  focus  in  the  abdomen  to  account  for 
the  infection  of  the  peritoneum;  it  is  assumed  that  the 
infection  has  reached  the  abdomen  by  the  blood  or  lymph 
stream,  or  from  some  injury  to  the  abdominal  wall,  such  as 
blows,  kicks,  gunshot  wounds  through  the  abdominal  walls, 
bowels,  etc.,  or  operations  of  various  kinds  on  the  organs  in 
the  abdominal  cavity. 

(6)  Secondary,  acute  peritonitis  is  due  to  infection  at  some 
localized  area  in  the  abdomen,  or  in  the  immediate  neighbor- 
hood, which  develops  rapidly  producing  a  diffuse  or  circum- 
scribed inflammation.  This  form  of  peritonitis  is  very 
common  in  animals  and  results  from  a  number  of  conditions. 
It  may  be  due  to  infection  from  the  abdominal  viscera, 
following  perforation  of  their  walls,  or  to  inflammation  and 
the  infection  passing  through  the  walls.  The  following  con- 
ditions are  frequent  causes:  Perforation  of  gastric  or 
duodenal  ulcer;  acute  toxic  gastro-enteritis;  mycotic  gastro- 
enteritis; traumatic  rupture  of  the  stomach  or  bowels; 
strangulation  of  the  bowels,  volvulus;  intussusception; 


PERITONITIS  251 

foreign  bodies  in  the  bowels;  iinpaction  of  the  bowels;  rupture 
of  abscesses  in  the  liver,  spleen,  omentura,  lymph  glands, 
etc.;  rupture  of  the  bladder  when  inflamed;  acute  phleg- 
monous,  or  gangrenous  cholecystitis;  metritis  and  para- 
metritis  after  parturition;  injuries  to  the  uterus  during 
parturition;  abscess  of  the  prostate  gland,  etc.  These  con- 
ditions allow  the  free  entrance  of  microorganisms,  or  reduce 
the  resistance  of  the  peritoneum  so  that  organisms  develop 
readily.  Numerous  organisms  are  found  producing  peri- 
tonitis, such  as  staphylococci,  diplococci,  streptococci, 
Bacillus  bipolaris,  Streptothrix  canis,  Bacillus  pyogenes, 
Bacillus  coli  communis.  In  chickens,  peritonitis  is  often 
found  as  a  prominent  condition  in  cholera,  and  also  from 
different  species  of  fungi,  such  as  Aspergillus  fumigatus, 
Aspergillus  glaucus,  etc.  A  fungoid  peritonitis  has  also 
been  observed  in  the  dog  produced  by  the  Sporotrichum 
beurmani.  Parasites  (Pleurocercoides  bailletis)  when  severe 
invasions  take  place  will  often  produce  peritonitis.  Exposure 
to  cold,  and  unsanitary  conditions  are  often  predisposing 
causes,  especially  in  dogs  and  birds. 

Pathogenesis. — As  soon  as  the  defensive  powers  of  the 
peritoneum  (the  phagocytic  action  of  the  endothelial  and 
other  cells,  the  bactericidal  power  of  the  peritoneal  fluid 
depending  on  the  presence  of  antibodies,  and  absorption 
which  destroy  and  remove  organisms)  are  neutralized  by 
any  of  the  etiological  factors  mentioned,  the  membrane 
becoming  dried  and  exposed  during  operations,  etc.,  or  the 
presence  of  solid  bodies,  particles  of  food,  blood  clots,  etc., 
the  resistance  of  the  peritoneum  is  lowered  and  its  absorbing 
and  bactericidal  power  interfered  with.  This  allows  the 
organisms  to  develop,  produce  their  toxins  and  an  acute 
peritonitis. 

Pathology.— According  to  the  character  of  the  exudation, 
peritonitis  can  be  classified  as  fibrinous,  serofibrinous,  fibrino- 
purulent,  suppurative  and  hemorrhagic.  The  character  ot 
the  inflammation  depends  greatly  on  the  nature  of  the  infec- 
tion. In  cases  of  low  virulence,  such  as  are  occasionally- 
observed,  the  serous  surfaces  present  little  more  than  a  slight 
loss  of  luster,  with  some  slight  deposits  of  delicate  fibrin.  In 


252  DISEASES  OF  THE  PERITONEUM 

the  ordinary  form,  in  the  early  stages,  there  is  marked 
congestion  of  the  serous  membrane,  later  the  serous  surface 
becomes  dull,  lusterless,  and  the  contiguous  surfaces  become 
slightly  adherent  through  the  depositing  of  yellowish-white 
flakes  of  fibrin  (peritonitis  fibrinosa).  In  some  instances 
there  is  but  little  effusion  of  fluid,  but  in  most  cases  there  is  a 
copious  effusion  of  exudation,  somewhat  turbid  containing  floc- 
culent  masses  of  a  yellowish  color  (peritonitis  serofibrinosa) . 
The  quantity  of  fluid  varies  considerably  from  a  few  cubic 
centimeters  to  several  liters.  In  other  cases  the  exudation 
is  more  turbid  and  contains  purulent  material  (peritonitis 
purulenta) .  The  peritonitis  following  rupture  of  the  bowels 
is  very  virulent,  the  exudation  is  purulent  and  contains 
bowel  contents.  In  the  abdominal  cavity  a  quantity  of  dirty, 
brown,  turbid  fluid  of  offensive  odor  is  found.  In  all  cases 
of  peritonitis  with  effusion  more  or  less  blood  is  always 
present  (peritonitis  hemorrhagica) .  When  the  peritonitis 
results  from  rupture  of  the  bladder,  urine  will  be  present  in 
the  abdominal  cavity,  and  the  odor  will  be  detected  in  the 
abdominal  contents. 

Symptoms.— Acute,  diffuse  peritonitis,  when  due  to  inju- 
ries, rupture  of  the  bowels,  abscesses,  etc.,  usually  develops 
rapidly  under  symptoms  of  marked  general  disturbance. 
In  the  most  severe  infections  the  symptoms  are  principally 
those  of  a  septicemia  or  toxemia.  In  the  beginning  there 
is  abdominal  pain,  restlessness,  stiff  unnatural  gait,  and 
"  tucked  up"  abdomen.  Palpation  over  the  abdomen  reveals 
intense  contraction  of  the  abdominal  muscles,  and  con- 
siderable sensitiveness.  When  the  peritonitis  is  .diffuse  the 
sensitiveness  is  noted  over  the  entire  abdomen;  when  cir- 
cumscribed only  local  areas  of  tenderness  are  evinced.  The 
pain  is  often  severe  enough  in  small  patients  (dog  and  cat) 
to  cause  them  to  groan  and  cry.  Pain  is  a  prominent 
symptom,  and  is  usually  continuous,  except  in  cases  where  a 
general  toxemia  exists.  The  respirations  are  of  the  costal 
type.  In  most  cases  they  are  diminished,  but  if  fluid  is 
present  there  is  severe  dyspnea. 

Vomiting  is  an  early  and  characteristic  symptom  of  peri- 
tonitis in  the  dog  and  cat.  It  is  usually  one  of  the  first 


PERITONITIS  253 

symptoms,  and  is  very  persistent.  The  vomitus  consists 
mainly  of  mucus,  food  particles,  bile,  and,  if  severe,  of  fecal 
matter. 

There  is  complete  loss  of  appetite  noted  early  in  the  course 
of  the  disease.  The  urine  is  decreased  in  quantity,  highly 
colored,  and  contains  a  large  amount  of  indican.  There  is 
often  severe  straining  as  if  to  urinate  (tenesmus  vesicae). 

In  the  early  stages  there  is  diarrhea  followed  later  by 
constipation  with  considerable  tympany.  In  the  very  early 
stages  the  temperature  in  the  dog  and  cat  is  elevated  (104- 
106°  F.).  The  temperature,  however,  remains  high  for  only 
a  few  hours  when  it  drops  rapidly  and  becomes  subnormal 
(96-100°  F.).  In  small  animals  the  temperature  in  perito- 
nitis is  usually  normal  or  subnormal. 

The  pulse  is  rapid,  small,  hard  and  often  wiry.  In  the 
later  stages  the  pulse  becomes  very  weak,  irregular,  and 
finally  imperceptible.  'The  extremities  grow  cold,  the 
mucous  membranes  cyanotic,  and  there  is  every  evidence  of 
a  deficient  heart  action. 

Effusion  of  fluid  (ascites)  is  usually  present  except  in  some 
of  the  more  acute  cases  which  are  rapidly  fatal.  The  per- 
cussion sound  is  flat,  the  area  of  dulness  shifting  as  the 
patient's  position  is  changed.  A  friction  sound  may  be 
present  in  the  early  stages,  but  due  to  the  effusion  which 
forms  early,  soon  disappears. 

In  some  cases  of  peritonitis,  due  to  severe  septic  infection 
(rupture  of  abscesses),  the  course  is  very  rapid  and  the 
general  symptoms  of  toxemia  are  the  only  ones  noticed. 
Peritonitis  following  rupture  of  the  stomach  or  bowel,  from 
severe  injury,  such  as  being  run  over,  kicks,  etc.,  runs  a  very 
rapid  course.  General  weakness,  coldness  of  the  extremities, 
and  coma  may  be  the  only  symptoms  noted. 

The  symptoms  of  circumscribed  peritonitis  are  similar  to 
those  of  diffuse,  except  that  they  are  so  mild  at  times  as 
to  be  overlooked. 

Course.— The  acute,  diffuse  peritonitis  usually  terminates 
in  death.  The  most  intensive  forms  usually  produce  death 
in  thirty-six  to  seventy-two  hours;  however,  most  commonly 
death  results  in  five  to  eight  days.  Some  of  the  milder  cases 


254  DISEASES  OF  THE  PERITONEUM 

terminate  in  recovery,  or  chronic  peritonitis,  which  runs  a 
long  chronic  course. 

Diagnosis.— In  typical  cases  the  sudden  onset,  the  sensi- 
tiveness over  the  abdominal  region,  the  fever,  the  wiry  pulse, 
the  development  of  effusion,  the  collapse  and  the  vomiting, 
present  a  rather  characteristic  picture.  In  some  cases  of 
rapid  development  the  diagnosis  is  very  difficult  and  is 
hard  to  differentiate  from  septicemia  or  toxemia. 

In  the  latter  stages  of  the  disease,  where  deep  coma  is 
present,  an  accurate  diagnosis  is  impossible.  Often  circum- 
scribed, acute  peritonitis  is  overlooked.  A  careful  examina- 
tion, therefore,  is  necessary  to  determine  the  exact  condition. 

Prognosis.— The  prognosis  in  acute,  diffuse  peritonitis  is 
unfavorable,  especially  if  it  follow  rupture  of  the  stomach, 
bowel  or  abdominal  abscesses.  Such  cases  invariably 
terminate  in  death.  In  circumscribed  fibrinous  or  sero- 
fibrinous  peritonitis  the  majority  of  cases  make  a  complete 
recovery.  Circumscribed  peritonitis,  however,  due  to  local 
infection  should  be  looked  upon  as  dangerous,  as  the  abscess 
may  rupture  into  the  abdominal  cavity  eventually  terminat- 
ing in  death  from  diffuse  peritonitis. 

Treatment.— Medical.— In  the  early  stages,  diarrhea  is 
present  and  fhe  peristalsis  active.  In  order  to  prevent 
friction  between  the  peritoneal  surfaces,  which  tends  to 
spread  the  inflammation,  small  doses  of  opium  (dog,  0.1-0.3; 
cat,  0.05-0.1),  or  morphin  sulphate  (dog,  0.016-0.12)  subcu- 
taneously  are  indicated. 

Cold  applications,  if  applied  early  to  the  walls  of  the 
abdomen,  are  indicated  (cold  water  compress  or  ice  pack)  to 
relieve  the  intense  congestion  of  the  serous  membrane.  Later 
counterirritants  may  be  used  in  the  form  of  oil  of  mustard 
mixed  with  olive  oil  (1-10).  Apply  by  rubbing  well  into  the 
skin  of  the  abdomen.  Hot  water  applications  may  also  be 
used.  Should  constipation  be  marked  laxatives  should  be 
given,  such  as  castor  oil  (dog,  15.0-30.0;  cat,  5.0-8.0)  or  mag- 
nesium sulphate  (dog,  10.0-14.0;  cat,  2.0-5.0).  Warm  water 
infusions  into  the  rectum  will  be  useful  to  remove  feces  and 
also  to  produce  a  soothing  action  on  the  membranes. 
General  stimulants  (strychnin  sulphate,  dog  0.001;  cat,  \ 


PERITONITIS  255 

the  quantity  subcutaneously)  are  employed  to  combat  symp- 
toms of  general  weakness  and  coma.  Alcoholic  stimulants 
or  camphor  may  also  be  used  for  the  same  purpose. 

Surgical.— When  severe  infection  is  present,  and  in  the 
early  stages,  it  is  advisable  to  irrigate  the  abdominal  cavity 
in  the  following  manner:  Laparotomy  should  be  performed 
(see  Laparotomy)  and  a  sufficient  amount  of  sterile,  normal 
salt  solution  introduced  at  the  body  temperature  to 
thoroughly  irrigate  all  parts  of  the  cavity.  This  should  be 
followed  by  a  boric  acid  (2  per  cent.)  or  a  salicylic  acid  solu- 
tion (2  per  cent.).  The  value  of  this  method  will  depend 
largely  upon  the  thoroughness  of  the  application.  Before 
irrigating  a  thorough  examination  of  the  organs  and  tissues 
in  the  cavity  should  be  made  for  ruptures,  etc.,  and  if  found, 
proper  treatment  should  be  applied.  When  an  excessive 
amount  of  effusion  is  present  it  should  be  removed.  (See 
Treatment  for  Ascites.) 

Chronic  Peritonitis.— Definition.— A  chronic  inflammation 
of  the  peritoneum  which  may  be  either  diffuse  or  circum- 
scribed. As  a  rule  chronic  peritonitis  is  rarely  found  equally 
well  marked  over  the  entire  abdominal  cavity.  From  a 
clinical  standpoint  it  is  difficult  to  separate  the  two  condi- 
tions, therefore,  they  will  be  described  as  one. 

Etiology.  — Chronic  peritonitis  may  be  due  to  a  number  of 
different  causes,  the  most  important  of  which  are:  Intra- 
abdominal  lesions,  such  as  diseases  of  the  liver  (hepatitis, 
abscesses),  the  kidneys,  spleen,  etc.,  which  may  reduce  the 
resistance  of  the  peritoneum;  or  from  gastric  or  duodenal 
ulceration  providing  a  focus  for  peritoneal  infection.  In 
these  cases  a  general  chronic  peritonitis  results  instead  of  a 
•local  inflammation,  owing  to  the  reduced  resistance  of  the 
membrane,  or  the  low  virulency  of  the  infection.  Chronic 
venous  engorgement  from  defective  heart  action  would 
produce  much  the  same  effect.  Chronic  peritonitis  may 
result  from  the  acute  fibrinous  form  when  complete  resolution 
does  not  take  place,  or  the  infection  is  mild. 

In  some  cases  it  may  result  from  disease  of  the  pleura  by 
spreading  through  the  diaphragm.  Chronic  peritonitis  may 
also  result  from  disturbances  of  the  intestinal  tract. 


256  DISEASES  OF  THE  PERITONEUM 

Ascites,  when  due  to  disease  of  the  heart,  may  produce 
chronic  peritonitis  by  lowering  general  resistance,  or  through 
organisms  which  gain  entrance  during  paracentesis  abdom- 
inis.  Parasites  (Linguatula  denticulatum,  Plerocercoides 
bailleti,  Echinococcus  granulosus)  in  the  dog  and  cat  may 
cause  chronic  peritonitis  by  the  constant  irritation  to  the 
peritoneum  they  produce. 

Pathology. — The  postmortem  lesions  vary  somewhat  de- 
pending upon  the  causes,  and  the  extent  of  the  process.  The 
peritoneum  is  covered  by  a  thick  membrane,  which  is  dull 
white  or  glistening,  pearl-like  in  color;  pigmentation  is  some- 
times present.  In  very  severe  cases  of  long  standing  this 
membrane  becomes  very  thick,  especially  over  the  visceral 
peritoneum,  and  can  be  peeled  off  from  the  organs.  Adhe- 
sions between  the  folds  of  the  visceral  peritoneum  are  often 
found,  which  may  bind  together  several  organs  into  one  mass. 
The  formation  of  this  membrane  is  due  mainly  to  an  organ- 
ization of  the  exudation  and  not  to  hyperplasia  of  the  peri- 
toneum itself. 

Symptoms.— The  symptoms  are  somewhat  similar  to  ascites. 
The  onset  is  gradual;  usually  no  symptoms  are  noted  until 
distention  of  the  abdomen  develops.  There  is  no  pain  or 
tenderness  on  manipulation.  On  percussion  a  dull  sound  is 
emitted,  and  on  auscultation,  especially  if  the  abdomen  be 
tapped  on  the  opposite  side  with  a  finger,  the  presence  of 
fluid  can  be  detected  by  the  splashing  sound  produced. 

There  are  usually  general  symptoms  of  dullness,  and  lack 
of  energy,  shown  by  the  animal  lying  down  a  great  deal  and 
refusing  .to  move  about.  The  patient  has,  as  a  rule,  a  good 
appetite  unless  constipated.  Respirations  are  increased 
owing  to  the  pressure  against  the  diaphragm. 

The  character  of  the  fluid  varies  somewhat.  It  has  a 
specific  gravity  of  about  1015,  is  of  a  yellowish  or  turbid 
color,  from  the  presence  of  large  numbers  of  cells,  and  when 
allowed  to  stand  it  usually  becomes  thick  and  forms  large 
amounts  of  floccuhv. 

The  temperature  in  the  dog  and  cat  remains  normal  or 
slightly  subnormal.  The  pulse  is^often  lapid  and  irregular. 


ASCITES  257 

Diagnosis.— The  character  of  the  fluid  in  the  abdomen  is 
one  of  the  chief  diagnostic  symptoms,  and  some  of  it  should 
be  obtained  and  examined  for  its  specific  gravity,  cells,  etc. 
A  careful  examination  of  the  animal  must  be  made  to  distin- 
guish this  from  ascites  due  to  other  causes.  The  anamnesis 
may  also  assist  in  making  the  diagnosis. 

Prognosis.— The  prognosis  is  unfavorable,  the  course 
chronic.  Complete  recovery  is  hardly  to  be  expected, 
although  a  number  of  cases  have  been  reported  where  appar- 
ent recoveries- have  taken  place.  Death  is  usually  the  result 
of  heart  failure. 

Treatment.— The  cause  should  be  ascertained  if  possible, 
and  the  treatment  given  accordingly.  If  the  cause  cannot 
be  determined,  symptomatic  treatment  is  given.  Diuretics, 
such  as  caffein  citrate  (0.1-0.3)  or  diuretin  (0.15-0.4)  are 
indicated  to  assist  in  removal  of  the  fluid. 

Paracentesis  abdominis  (see  Ascites)  should  be  performed 
whenever  necessary  to  remove  the  fluid  from  the  cavity. 
The  dog,  as  a  rule,  responds  more  readily  to  treatment  than 
the  cat. 

ASCITES. 

Hy drops  Abdominis.     Hydrops  Ascites.     Hydrops  Peritonei. 

Definition.— A  collection  of  serous  fluid  in  the  abdominal 
cavity.  This  condition  is  quite  common  in  dogs,  and  also 
occurs  in  cats  and  birds.  Mild  cases  of  ascites  are  often 
overlooked  during  life,  and  are  only  found  on  postmortem  or 
during  operations  on  the  abdominal  cavity. 

Etiology.— 1.  Local  Causes.— (a)  Chronic  inflammation  of 
the  peritoneum,  either  simple,  carcinomatous,  sarcomatous, 
or  by  cysts  of  parasites  (Plerocercoides  bailleti,  Linguatula 
denticulatum,  etc.).  (6)  Obstruction  to  the  portal  vein, 
either  in  its  terminal  branches  in  the  liver,  such  as  by 
cirrhosis,  chronic,  passive  congestion,  etc.,  or  by  compression 
of  the  vein  in  the  gastrohepatic  omentuin,  such  as  by  pro- 
liferative  peritonitis,  abscesses,  tumors  (sarcomas,  carci- 
nomas, etc.),  or  by  aneurysm.  (c)  Thrombosis  of  the  portal 
vein.  (fT)  Tumors  in  the  abdominal  cavity  in  general,  (e) 
17 


258  DISEASES  OF  THE  PERITONEUM 

Cysts  of  the  ovaries  (common  in  cats).  (/)  Occurs  in  the 
secondary  stage  of  acute  circumscribed  or  diffuse  peritonitis. 

2.  General  Causes.— Ascites  often  occurs  as  a  symptom  of 
general  dropsy,  the  result  of  mechanical  effects,  as  in  heart 
diseases,  chronic  indurative  or  interstitial  pneumonia.  In 
some  heart  diseases  the  effusion  is  confined  to  the  abdominal 
cavity,  in  which  case  it  is  no  doubt  due  to  secondary  changes 
in  the  liver.  Ascites  also  occurs  in  chronic  diseases  of  the 
liver.  In  young  dogs  (puppies)  ascites  is  frequently  observed, 
and  often  disappears  as  the  animal  develops,  apparently 
without  any  particular  cause  being  found. 

Pathology.  —The  presence  of  fluid  in  the  abdominal  cavity, 
of  varying  quantity  from  a  few  cubic  centimeters  to  15-20 
liters.  This  fluid  has  a  specific  gravity  of  1012-1015,  a  light 
or  yellowish  color,  clear,  and  contains,  as  -a  rule,  but  a  slight 
amount  of  fibrin,  or  flocculent  precipitate.  The  chemical 
reaction  of  the  fluid  is  alkaline  or  neutral;  the  albumin  con- 
tent is  about  2  to  5  per  cent.  Sometimes  the  fluid  wTill  be  of  a 
reddish  color,  due  to  slight  hemorrhages,  or  to  some  of  the 
red  cells  passing  out  with  the  serum.  This  is  especially 
noticeable  in  obstruction  to  the  portal  vein.  A  greenish" 
cast  is  noticed  when  the  liver  is  secondarily  affected.  The 
precipitate  when  examined  will  be  found  to  contain  a  small 
number  of  leukocytes,  fatty  endothelial  cells,  flakes  of  fibrin, 
and  sometimes  red  cells,  and  in  rare  cases  numbers  of  small 
cysts  of  parasites.  In  dogs  and  cats  the  fluid  often  contains 
numerous  fat  cells  and  has  a  milky  appearance. 

The  peritoneum  is  usually  pale,  glistening,  thickened, 
especially  in  cases  of  long  standing  or  those  due  to  chronic 
peritonitis.  The  organs  in  the  cavity  are  usually  anemic, 
dull  on  the  surface  and  sometimes  atrophic. 

Symptoms.— An  enlargement  of  the  abdomen  is  usually 
the  first  indication  of  the  disorder.  Until  the  accumulation 
of  fluid  becomes  great  enough  to  cause  a  distention  of  the 
abdomen,  the  symptoms  will  not  be  positive  enough  to  make 
a  diagnosis.  As  the  amount  of  fluid  in  the  abdomen  varies 
greatly,  the  symptoms  will  vary  considerably  in  individual 
cases.  The  fluid  distends  the  abdominal  wall,  causing  the 
muscles  and  skin  to  become  tense,  and  the  abdomen  to  assume 


ASCITES  259 

a  characteristic  pear  shape.  When  the  animal  assumes  a 
standing  posture,  the  fluid  collects  in  the  lower  portion  of  the 
abdomen  and  the  amount  can  be  rather  accurately  deter- 
mined by  percussion.  Above  the  line  of  dulness  will  be 
noticed  a  tympanitic  sound.  Changing  the  position  of  the 
animal  causes  a  shifting  of  the  horizontal  line  which  marks 
the  upper  limits  of  the  area  of  dulness. 

On  palpation  the  resistance  is  fairly  uniform.  By  placing 
one  hand  on  the  side  of  the  abdomen,  and  tapping  gently  on 
the  other  side  with  the  other  hand,  a  plain  undulation  will  be 
felt.  As  the  amount  of  fluid  increases,  pressure  is  produced 
on  the  diaphragm,  interfering  with  the  function  of  the  organs 
in  the  thoracic  cavity.  Severe  dyspnea  with  cyanotic  mem- 
branes is  noted  in  some  cases.  The  pulse  is  weak  and  rapid. 
As  the  cases  progress,  emaciation  appears.  The  appetite 
is  impaired,  the  digestive  tract  disturbed  and  occasional 
attacks  of  vomiting  occur.  The  temperature  is  normal;  in 
the  later  stages  it  may  be  subnormal.  The  urine  is  reduced 
in  amount,  and  often  highly  colored  in  the  dog;  otherwise  it 
is  normal.  The  animal  may  die  from  general  exhaustion, 
or  from  asphyxia. 

Diagnosis.— The  diagnosis  is  not  difficult,  provided  a  care- 
ful examination  is  made  of  the  patient,  its  history  obtained, 
and  all  the  symptoms  carefully  noted.  However,  there  are 
quite  a  number  of  conditions  with  which  ascites  might  be 
confused.  It  might  be  mistaken  for  acute  or  chronic  peri- 
tonitis with  effusion.  By  puncturing  the  abdominal  wall  with 
an  explorative  trocar  and  obtaining  some  of  the  fluid,  a  dif- 
ferential diagnosis  can  be  made. 

Excessive  accumulation  of  fat  (obesity)  might  be  confusing. 
However,  obesity  occurs  mostly  in  old  animals,  and  the  shape 
of  the  abdomen  is  more  apple  (broad  back,  well  rounded 
barrel)  than  pear  shaped. 

Advanced  pregnancy  can  be .  differentiated  by  careful 
palpation  which  will  reveal  the  presence  of  the  fetuses. 
Tumors  in  the  cavity  can  be  differentiated  by  their  consist- 
ency and  their  permanent  position.  Distention  «>t  the 
bladder  produces  an  enlargement  which  remains  in  the  same 
position  at  all  times,  and  when  palpated  can  be  felt  as  a 


260  DISEASES  OF  THE  PERITONEUM 

large  body  within  the  cavity.  Passing  the  catheter  will 
reduce  the  enlargement  by  removing  the  urine. 

Rupture  of  the  bladder,  when  distended,  will  produce  a 
sudden  distention  of  the  abdomen,  and  general  symptoms  of 
stupor  and  coma  often  with  convulsions.  Puncturing  the 
abdomen  will  reveal  the  presence  of  urine. 

Prognosis.  —The  prognosis  depends  largely  upon  the  cause. 
As  a  rule,  it  is  unfavorable. 

Treatment.—  Medical.—  The  cause  should  first  be  deter- 
mined, if  possible,  and  measures  taken  to  eliminate  it. 
Should  the  heart  action  be  deficient,  digitalis  would  be 
indicated  (dog,  0.05-0.10;  cat,  ^  quantity)  to  stimulate  the 
heart  and  overcome  venous  stasis.  This  drug  is  further  of 
great  value  owing  to  its  diuretic  action,  which  assists  in  the 
elimination  of  fluid  from  the  body.  Caffein  citrate  (dog, 
0.1-0.5;  cat,  0.05-0.1)  has  a  similar  action.  The  resorption 
of  the  exudate  may  also  be  aided  by  the  use  of  diuretics: 
Potassium  acetate  (dog,  0.5-0.8;  cat,  0.05-0.1) ;  bulbous  scillee 
in  powder  form  (dog,  0.05-0.2;  cat,  0.01-0.05) ;  diuretin  (dog, 
0.5-1.0;  cat,  0.01-0.05)  every  two  or  three  hours,  or  agurin 
(dog,  1.0-2.0;  cat,  0.02-0.08)  daily.  Laxatives  should  be 
administered  occasionally  to  keep  the  bowels  open  which 
also  assists  in  removing  the  fluid.  Magnesium  sulphate 
(dog,  8.0-14.0;  cat,  1.0-4.0)  is  best  for  this  purpose.  Dia- 
phoretics may  also  be  administered,  although  not  so  impor- 
tant in  small  animals  as  in  large  ones,  as  the  skin  glands  are 
less  developed.  Pilocarpin  hydrochlorate  (dog,  0.005-0.01) 
can  be  used,  but  there  is  some  danger  of  edema  of  the  lungs 
or  paralysis  of  the  heart  from  its  use. 

Surgical.— If  the  fluid  produces  severe  dyspnea  and  inter- 
feres with  the  action  and  function  of  abdominal  and  thoracic 
organs,  it  should  be  removed  surgically  by  performing  para- 
centesis  abdominis.  The  operation  is  as  follows:  The 
animal  is  placed  in  a  standing  position,  or  on  its  side  on  the 
operating  table  and  the  hair  shaved  from  a  small  area  at 
the  most  pendent  portion  of  the  abdomen,  usually  near  the 
umbilicus.  The  surface  should  be  thoroughly  disinfected  by 
washing  with  bichJorid  soap,  followed  by  alcohol,  and 
tincture  of  iodin  painted  over  the  surface  where  the  puncture 


ASCITES  201 

is  to  be  made.  A  small  exploring  trocar  is  used,  which 
should  be  sterilized,  and  inserted  through  the  abdominal 
walls.  When  the  stylet  is  withdrawn,  the  fluid  will  usually 
flow  out  in  a  stream.  Sometimes  the  end  of  the  cannula 
becomes  blocked  by  omentum  or  bowel.  This  can  be  over- 
come by  moving  the  cannula  slightly  or  by  re-inserting  the 
stylet.  The  fluid  should  be  collected  in  a  vessel  to  note  its 
character.  The  amount  of  fluid  to  remove  depends  largely 
upon  the  condition  of  the  animal.  Should,  however,  symp- 
toms of  dyspnea,  cyanosis,  and  rapid,  weak  pulse  appear, 
the  cannula  should  be  at  once  removed.  The  operation 
may  be  repeated  next  day.  The  punctured  wound  resulting 
from  the  operation  should  be  protected  by  covering  with 
collodion  and  a  small  pledget  of  cotton.  Death  occurs 
occasionally  from  collapse  following  the  operation.  There- 
fore the  patient  should  be  carefully  watched  and  the  removal 
of  the  fluid  stopped,  and  general  stimulants  given,  when 
signs  of  collapse  appear. 


PART  IV. 
DISEASES  OF  THE  REPRODUCTIVE  ORGANS. 


CHAPTER   I. 
DISEASES  OF  THE  PENIS  AND  PREPUCE. 

Examination.— The  prepuce  should  be  examined  by  observ- 
ing the  discharge  at  its  opening,  and  the  condition  of  the 
mucous  membrane.  Frequently  there  will  be  found  a  more 
or  less  extensive  mucopurulent  discharge  which  indicates  a 
catarrhal  inflammation  of  the  prepuce.  The  preputial  open- 
ing should  be  dilated  and  the  mucosa  examined  for  foreign 
bodies,  tumors,  ulcerations,  secretions,  etc. 

The  penis  may  be  examined  in  the  following  manner: 
The  animal  should  be  placed  in  the  dorsal  position,  and 
either  held  by  assistants,  or  securely  fastened  to  the  table 
with  hopples.  With  the  left  hand,  the  prepuce  is  gently 
pushed  downward  and  backward,  exposing  the  free  end  of  the 
penis.  The  penis  is  then  grasped  with  the  fingers  of  the 
other  hand  and  pulled  as  far  out  of  the  prepuce  as  possible. 
A  piece  of  tape  should  be  placed  around  the  penis  just 
posterior  to  the  glans,  and  with  gentle  traction  the  penis  can 
be  exposed  for  a  considerable  distance.  The  penis  should  be 
examined  for  inflammations,  tumors,  venereal  granulomata, 
rubber  bands,  wounds,  fractures  of  the  os  penis,  etc. 

WOUNDS  OF  THE  PENIS  AND  PREPUCE. 

There  are  quite  a  variety  of  injuries  which  are  found 
involving  these  structures.  Principally,  injuries  result  from 


264        DISEASES  OF  THE  PENIS  AND  PREPUCE 

the  bites  of  other  animals,  and  different  degrees  of  the  con- 
ditions are  found,  from  small  cuts  of  the  prepuce  to  extensive 
laceration  of  the  tissues.  Rubber  bands  are  occasionally 
found  on  the  penis  just  back  of  the  glans.  These,  if  left  on 
very  long,  result  in  extensive  edema  and  necrosis  of  a  portion 
of  the  penis.  Injuries  also  occur  during  coition  as  the  penis 
is  retained  in  the  vagina  until  the  semen  is  ejaculated,  which 
requires  several  minutes  in  the  dog,  and  during  which  time 
the  movement  of  the  female  will  often  cause  torsion  or 
twisting  of  the  penis  with  subsequent  edema.  Frequently 
dogs  are  roughly  handled  at  this  time  and  the  penis  lacerated 
or  cut.  The  prepuce  is  often  found  split  from  being  cut  by 
sharp  objects,  or  perforations  occur  which  allow  the  penis  to 
prolapse  through  the  opening. 

Symptoms.— The  symptoms  depend  to  a  great  extent  upon 
the  kind  of  injury  and  the  amount  of  damage  done  to  the 
tissues.  Attention  to  wounds  of  the  prepuce  will  be  drawn 
by  the  hemorrhage  and  swelling.  Examination  reveals  the 
extent  of  the  wound.  In  edemas  of  the  penis,  the  animal 
shows  difficulty  in  urination,  the  penis  often  projecting 
from  the  prepuce,  swollen,  reddened,  and  if  strangulated 
will  be  of  a  dark  color  (venous  stasis).  Thorough  examina- 
tion should  be  made  to  determine  the  degree  of  injury,  and 
to  discover  any  foreign  bodies  which  might  be  present. 

Prognosis.— Favorable  in  most  cases,  as  wounds  in  this 
location  respond  to  treatment  readily.  Not  so  favorable  in 
cases  of  strangulation  of  the  penis  with  subsequent  necrosis. 

Treatment. —The  parts  must  be  thoroughly  cleansed, 
washed  with  an  antiseptic  solution,  and  the  character  of  the 
injury  determined.  Wounds  in  the  prepuce,  such  as  cuts  or 
perforations,  are  sutured  after  thorough  disinfection  and  all 
ragged  edges  removed  with  the  scissors.  Injuries  to  the 
penis  should  be  looked  after  carefully,  as  they  sometimes 
lead  to  sufficient  swelling  to  interfere  with  the  discharge  of 
urine.  In  such  cases,  the  catheter  is  introduced  and  the 
urine  withdrawn.  Should  this  procedure  fail,  make  an 
opening  in  the  urethra  at  the  ischial  arch  to  temporarily  take 
care  of  the  discharge  of  urine.  Applications  of  antiseptic 
solutions  for  a  few  days  will  reduce  the  inflammation  and 


PREPUTIAL  CATARRH  205 

infection.  When  the  penis  is  strangulated  and  necrotic,  it  is 
advisable  to  amputate  the  affected  portion.  This  is  done 
in  the  following  manner:  The  animal  is  anesthetized, 
placed  on  the  table  in  a  dorsal  position  and  securely  hoppled. 
The  parts  should  be  thoroughly  cleansed  with  soap  and  water 
and  disinfected.  Pull  the  penis  out  of  the  prepuce  as  far  as 
possible,  and  apply  a  rubber  tourniquet  at  a  point  above  the 
seat  of  operation  to  control  the  helnorrhage.  Incise  the 
penis  with  a  scalpel,  and  if  it  is  necessary  to  amputate  through 
the  os  penis  a  saw  should  be  used  for  this  portion.  The 
urethra  is  protected  by  a  catheter  previously  inserted,  and 
left  about  one-half  inch  longer  than  the  stump  of  the  penis. 
It  is  split  with  the  scissors  on  its  dorsal  surface  back  to  where 
the  penis  was  incised.  The  flaps  of  the  urethra  are  then 
securely  stitched  to  the  stump  of  the  penis  to  prevent  a 
stricture  forming  at  this  point.  All  vessels  should  be  ligated, 
and  the  parts  again  washed  with  an  antiseptic  solution.  The 
tourniquet  is  removed  and  the  penis  allowed  to  retract  back 
into  the  prepuce.  Cleanse  daily  with  antiseptics. 

CONGENITAL  MALFORMATIONS. 

Malformations  of  these  structures  are  not  common. 
Arrested  development  of  the  penis  or  prepuce  is  seen  occa- 
sionally. Hermaphrodites  are  not  common  among  dogs. 
Congenital  closure  of  the  prepuce  is  observed  sometimes  in 
puppies,  which  must  be  opened  with  a  scalpel  and  the  edges 
of  the  skin  stitched  back  to  prevent  adhesions. 

PREPUTIAL  CATARRH. 

Balanitis. 

Definition.— A  catarrhal  inflammation  of  the  mucous 
membrane  of  the  prepuce. 

Etiology.— Preputial  catarrh  may  be  produced  by  several 
different  factors: 

(a)  Principally  local  infection. 

(6)  Develops  in  a  number  of  cases  secondary  to  other 
diseases;  venous  stasis;  phimosis;  paraphimosis;  injuries, 
or  foreign  bodies. 


266         DISEASES  OF  THE  PENIS  AND  PREPUCE 

(c)  Sequel  to  specific  infectious  diseases,  as  distemper. 

(d)  Follows  in  some  cases  of  mange  and  eczema. 

In  all  of  the  above  causes  we  find  that  the  condition  is 
brought  about  by  infection  either  as  a  primary  cause,  or  due 
to  reduced  resistance  of  the  tissues  by  other  diseases  which 
allows  secondary  infection  to  take  place.  In  some,  accumu- 
lations of  dirt  will  favor  injury  to  the  mucosa  with  subsequent 
infection. 

Symptoms. —The  mucosa  of  the  prepuce  will  be  injected, 
swollen,  and  there  is  present  at  the  preputial  opening  a  dis- 
charge of  pus  of  a  yellowish  or  greenish  color.  Some  of  the 
material  accumulates  around  the  preputial  opening  aggluti- 
nating the  hair,  drying  and  forming  crusts.  Examination 
of  the  mucosa  shows  a  marked  catarrhal  inflammation. 

Prognosis.— The  condition  is  not  serious  as  in  most  cases  it 
remains  local.  When  treatment  is  applied,  recovery  takes 
place  after  a  few  weeks. 

Treatment. —The  parts  are  thoroughly  cleansed  and  all 
long  hairs  removed  with  the  scissors.  The  prepuce  should 
be  washed  thoroughly  once  or  twice  daily  with  antiseptic 
and  astringent  solutions  (alum,  2  per  cent.;  silver  nitrate, 
j  per  cent.;  zinc  sulphate,  1  per  cent.). 

PfflMOSIS. 

Definition.— A  contraction  of  the  prepuce  in  front  of  the 
glans  penis,  preventing  the  projection  of  the  penis,  interfering 
with  coition,  and  in  some  cases  the  escape  of  urine. 

Etiology.— Phimosis  is  a  congenital  defect  in  puppies.  It 
may  cause  in  some  cases  almost  complete  occlusion.  It 
results  frequently  from  trauma  of  various  kinds,  the  subse- 
quent cicatricial  tissue  formed  leading  to  constriction.  Acute 
infectious  inflammation  (balanitis)  with  severe  swelling  will 
produce  a  temporary  closure,  and  in  some  cases,  owing  to 
the  change  in  the  structure  of  the  tissues,  a  permanent 
contraction. 

Symptoms.— In  puppies  it  will  be  noticed  that  urine  cannot 
be  discharged;  there  may  be  frequent  attempts  at  micturition, 
with  only  a  small  quantity  passed  or  there  may  be  complete 


PARAPH I MOSIS  267 

suppression.  In  mature  animals  the  same  symptom  of 
difficulty  in  passing  urine  is  often  present.  There  is  a 
narrowing  of  the  preputial  opening;  sometimes  it  is  exceed- 
ingly small.  Animals  suffering  from  phimosis  are  unable  to 
copulate. 

Treatment.— In  phimosis  surgical  relief  should  be  given 
promptly.     There  are  two  methods  employed: 

(a)  The  patient  is  placed  in  a  dorsal  position  on  the 
table  and  the  parts  disinfected.     A  longitudinal  incision  of 
sufficient  length  is  made  on  the  inferior  portion  of  the  prepuce 
to   allow   the   penis   to   protrude.     The   two   portions   are 
temporarily  stitched  back  to  the  skin  to  prevent  adhesions 
and  a  recurrence  of  the  condition.     The  wound  should  be 
treated  daily  with  antiseptics. 

(b)  The  animal  is  placed  in  the  same  position  as  above  and 
local  or  general  anesthesia  given.     A  circular  incision  is 
made  completely  around  the  prepuce,  removing  about  one- 
quarter  to  one-half  inch  of  its  end.     The  hemorrhage  is 
usually  slight.     The  mucosa  should  be  stitched  to  the  skin 
for  the  entire  distance  around  the  prepuce.     This  will  insure 
a  preputial  opening  of  sufficient  size.     Care  must  be  taken 
in  this  operation  not  to  remove  too  much  of  the  prepuce,  as 
it   would   allow   prolapsus   of   the   penis.     After-treatment 
consists  in  cleaning  and  disinfecting  the  parts  daily. 


PARAPfflMOSIS. 

Definition.— A  contraction  of  the* prepuce  around  the  penis, 
preventing  the  penis  from  assuming  its  normal  position. 

Etiology.  —  Paraphimosis  can  result  from  coition.  The 
prepuce  becomes  inverted  when  the  penis  retracts,  but  the 
resulting  swelling  prevents  complete  retraction.  As  a  result 
of  coition,  with  subsequent  swelling,  the  penis  becomes  too 
large  to  pass  through  the  preputial  opening.  It  is  further 
observed  in  some  cases  of  paralysis  of  the  penis,  organic- 
changes  having  taken  place  in  the  tissues  from  exposure. 
Neoplasms,  such  as  granulomata,  are  sometimes  productive 
of  the  same  condition. 


268         DISEASES  OF  THE  PENIS  AND  PREPUCE 

Symptoms. —The  exposed  penis  becomes  swollen,  edema- 
tous  and  discolored  and  when  strangulated,  gangrenous. 
The  animal  will  have  difficulty  in  voiding  urine  due  to  the 
•swelling  and  compression  of  the  urethra.  There  is  stiffness 
in  walking.  Examination  of  the  parts  will  at  once  reveal  the 
exact  nature  of  the  condition. 

Prognosis.— In  early  cases,  resulting  from  coition,  the 
prognosis  is  favorable.  In  cases  of  long  standing,  after 
strangulation,  or  in  paralysis,  the  prognosis  is  unfavorable. 

Treatment.— In  early  cases  of  paraphimosis,  following 
coition  and  before  much  swelling  has  taken  place,  it  is 
possible  in  most  cases  to  correct  the  inversion  of  the  prepuce 
and  return  the  penis  to  its  normal  position.  This  is  best 
done  by  cleansing  and  disinfecting  the  parts  thoroughly, 
lubricating  the  penis  and  preputial  ring  with  some  bland  oil 
(olive),  and  by  manipulating  the  parts  by  pressing  on  the 
glans  penis.  If  at  the  same  time  the  prepuce  is  pressed  for- 
ward, the  parts  will  often  be  reduced  without  much  difficulty. 
Should  this  procedure  fail,  it  is  advisable  to  reduce  the  con- 
gestion of  the  glans  penis  by  bathing  in  cold  water,  applying 
alum  solution  (2-5  per  cent.),  or  by  applying  tape  tightly 
around  the  glans.  After  the  congestion  has  been  reduced, 
manipulation  as  above  will  often  reduce  the  condition. 
These  manipulations  will  not  suffice  in  cases  which  have 
become  greatly  swollen  or  edematous.  It  is  then  necessary 
to  resort  to  an  operation,  which  consists  in  simply  splitting 
the  prepuce  longitudinally  on  its  lower  surface,  making  a  slit 
of  a  sufficient  length  to  relieve  the  strangulation  and  allow 
the  penis  to  retract.  Where  gangrenous  conditions  have 
developed,  amputation  of  the  penis  must  be  resorted  to. 
After-treatment  in  these  cases  consists  in  applying  antiseptic 
solutions  freely. 


TUMORS  OF  THE  PENIS  AND  PREPUCE. 

Various  forms  of  tumors,  both  benign  and  malignant,  are 
found  in  this  location.  The  following  varieties  are  most 
common : 


TUMORS  OF  THE  PENIS  AND  PREPUCE          209 

Papillomata.— These  in  most  cases  involve  the  prepuce. 
They  are  small,  benign  growths,  appearing  usually  as  pedun- 
culated  warts.  Sometimes  they  are  found  in  large  numbers 
with  irregular  or  cauliflower-like  surfaces  and  are  usually 
found  at  the  juncture  of  the  skin  and  mucous  membrane. 

Symptoms.— They  produce,  as  a  rule,  no  marked  symptoms 
of  any  kind,  except  in  some  cases  a  catarrh al  inflammation 
of  the  prepuce  (balanitis) . 

Treatment.— Tumors  should  be  removed  with  scissors  as 
close  to  the  base  as  possible.  Cauterize  the  base  with  silver 
nitrate.  A  recurrence  is  unusual. 

Sarcomata,  Epitheliomata  and  Carcinomata.— These  are 
occasionally  found  involving  the  prepuce  and  penis.  These 
tumors  are  malignant  and  show  much  the  same  character- 
istics from  a  clinical  standpoint. 

Symptoms.  —  In  most  cases  these  tumors  involve  the  pre- 
puce. They  are  characterized  by  their  sudden  development, 
irregular  outline,  degenerative  changes,  and  tendency  to 
spread  into  the  adjacent  tissues.  They  usually  present  a 
raw,  ulcerating  surface,  show  a  tendency  to  bleed,  etc. 

Diagnosis. — The  diagnosis  depends  upon  the  characteristic 
growth,  and  the  microscopic  findings. 

Treatment.— In  case  a  diagnosis  of  malignant  tumor  is 
positively  made,  the  results  of  treatment  are  only  temporary. 
Removal  of  the  tumor  is  advised,  and  the  incised  portion 
should  contain  not  only  all  of  the  malignant  growth  but  also 
include  a  small  portion  of  adjacent  normal  tissue.  Malignant 
tumors  are  liable  to  recur  in  a  short  time. 

Venereal  Granulomata.  —  This  is  a  specific,  infectious 
tumor  formation  affecting  the  penis  and  prepuce  of  the  dog. 
It  is  transmitted  in  most  cases  by  the  act  of  copulation. 
Affected  stud  dogs  transmit  it  during  coition.  It  may  be 
transmitted  in  rare  instances  by  intermediary  agents.  It  is 
far  more  common  in  Europe  than  in  the  United  States  where 
it  has  been  introduced  by  imported  stud  dogs.  The  growth 
seems  to  confine  itself  to  the  prepuce,  penis,  and  immediately 
adjacent  tissues  with  involvement  of  the  efferent  lymphatics. 

Symptoms.— Venereal  granulomata  are  usually  found  only 
in  the  best  bred  dogs.  The  early  symptoms  are  redness, 


270        DISEASES  OF  THE  PENIS  AND  PREPUCE 

swelling  and  a  reddish  colored  discharge  from  the  prepuce. 
Micturition  is  frequent,  and  the  penis  is  protruded  from  the 
prepuce.  On  palpation  the  prepuce  will  be  found  swollen 
and  irregular  in  outline.  On  exposing  the  penis,  it  will  be 
tumified,  purplish  or  dark  red  in  color,  and  on  its  surface 
presents  a  number  of  vegetative  growths.  These  growths 
may  be  found  also  on  the  prepuce.  They  are  characterized 
by  their  soft  friable  condition,  tendency  to  bleed  at  the  least 
touch;  they  may  be  sessile  or  pedunculated.  The  growths 
first  appear  in  the  form  of  small  vesicles,  which  soon  develop 
into  pimples  at  first  of  a  firm  consistency,  but  as  they  grow 
become  softer  and  more  friable.  Their  growth  is  slow.  In 
six  months  to  one  year  they  can  involve  most  of  the  prepuce 
and  penis.  Examination  of  the  inguinal  lymph  glands  often 
reveals  enlargement  and  secondary  changes. 

Diagnosis.— This  must  be  based  mainly  on  the  infectious 
character  of  the  growth  (its  spread  by  coition),  and  its  char- 
acteristic development. 

Prognosis.— The  tendency  to  reappear  after  removal  and 
the  spread  to  other  animals  make  the  prognosis  unfavorable. 
Often  when  the  growths  are  removed  from  one  area  they 
reappear  on  another. 

Treatment.  — Complete  removal  of  the  growths  surgically 
is  recommended  when  possible.  On  account  of  the  tendency 
to  recur,  they  should  be  completely  dissected  out,  even  includ- 
ing some  of  the  normal  mucosa.  It  is  advisable  to  cauterize 
the  surface  after  their  removal,  and  to  treat  the  wounds  with 
antiseptics.  In  all  cases  the  patient  must  be  closely  observed 
and  at  the  first  sign  of  recurrence  of  the  growths,  promptly 
operated.  In  advanced  cases,  with  extensive  involvement 
of  both  the  penis  and  prepuce,  and  where  general  symptoms 
of  emaciation  and  weakness  are  present,  the  penis  should 
be  amputated  even  including  a  portion  of  the  prepuce. 


CHAPTER   II. 
DISEASES  OF  THE  TESTES  AND  SCROTUM. 

WOUNDS  AND  INJURIES  OF  THE  TESTES  AND  SCROTUM. 

In  the  dog  and  cat  wounds  and  injuries  of  these  organs 
are  of  frequent  occurrence,  partly  accidental  and  partly 
intentional.  Attempts  at  castration  with  the  escape  of  the 
animal  before  completion  of  the  operation  is  a  common  con- 
dition. There  will  be  incised  wounds  of  the  scrotum  and  in 
some  cases  even  exposure  of  the  testes.  Bites  from  other 
animals,  such  as  dogs,  cats,  and  rats,  produce  a  variety  of 
wounds  and  injuries  to  the  testes.  Being  run  over  by  vehicles 
is  a  common  source  of  injury  to  these  organs. 

Symptoms.— Hemorrhage  from  the  scrotum  will  be  noted 
in  the  case  of  wounds,  which  should  always  be  examined 
carefully  to  determine  the  extent  of  the  injury.  Contused 
wounds  or  bruises  are  always  characterized  by  swelling, 
stiffness,  straddling  gait,  and  pain  on  manipulating  the  testes. 

Prognosis.— Wounds  in  this  location  are  not  as  a  rule 
unfavorable,  although,  if  extensive,  castration  of  the  animal 
may  be  necessary.  Slight  wounds  heal  rapidly. 

Treatment.— Small,  incised  wounds  of  the  scrotum  should 
be.  cleansed  thoroughly  with  antiseptics,  at  least  once  daily. 
If  the  wound  is  recent  it  should  be  cleansed,  the  hemorrhage 
controlled,  and  sutured.  Cover  the  sutures  with  an  imper- 
vious dressing  like  flexible  collodion. 

In  case  the  testicles  are  exposed,  they  should  be  removed. 
(See  Castration.)  Contusions  must  be  treated  as  in  orchitis. 

ORCHITIS. 

Definition.— An  inflammation  of  one  or  both  testicles. 
Etiology.— Orchitis  occurs  in  the  dog  and  cat  from  bruises, 
or  bites  of  other  animals.     Being  run  over  by  vehicles  is  a 


272       DISEASES  OF  THE  TESTES  AND  SCROTUM 

cause.  Orchitis  may  be  a  sequel  to  wound  infection,  to 
distemper  in  the  dog  and  cat,  and  the  spread  of  infection 
from  adjacent  organs  and  tissues. 

Symptoms.— The  first  symptoms  noticed  are  those  of 
enlargement  of  one  or  both  testes;  pain  on  manipulation  of 
the  organs;  and  a  stiff,  straddling  gait.  We  should  not  mis- 
take thickening  of  the  scrotiun,  a  common  condition  in  old 
dogs,  for  orchitis.  If  due  to  infection  there  will  be  more  or 
less  elevation  of  temperature,  and  other  symptoms  of  the 
primary  condition.  The  local  temperature  is  also  increased. 

Prognosis. — In  orchitis  from  injuries,  most  cases  terminate 
favorably.  In  the  infective  form  the  gland  may  be  destroyed, 
or  becomes  chronic  and  the  patient  impotent. 

Treatment.— In  the  early  stages  cold  packs  should  be 
applied,  as  cold  water  or  a  small  sack  filled  with  cracked  ice. 
The  ice  or  water  pack  can  be  held  in  place  by  a  bandage 
passed  around  the  abdomen  just  anterior  to  the  pelvis,  and 
fastened  over  the  back  and  between  the  limbs.  It  should  be 
renewed  after  a  few  hours  to  keep  up  the  refrigeration.  After 
the  swelling  and  pain  have  subsided,  the  pack  can  be  gradu- 
ally discontinued. 

In  subacute  or  chronic  cases  of  orchitis,  hot  packs  are 
indicated,  best  in  the  form  of  hot  water,  applied  in  the  same 
manner  as  above.  Massaging  with  a  small  amount  of  anti- 
septic ointment  is  recommended,  following  the  hot  packs. 
In  the  infective  form  hot  packs  should  be  used  with  hot 
water  to  which  has  been  added  some  antiseptic.  Abscesses 
must  be  opened  and  treated  with  antiseptics.  Should  they 
involve  the  testicles  it  is  best  to  remove  them.  (See  Cas- 
tration.) 


TUMORS  OF  THE  SCROTUM  AND  TESTES. 

Several  forms  of  tumors  are  found  in  these  organs: 

(a)  Fibromata.— In  old  dogs  a  marked  thickening  of  the 

scrotum  is  common.    It  is  due  either  to  an  eczema,  or  from 

the  constant  irritation  from  sitting  on  the  testicles.    The 

latter  is  characterized  by  absence  of  hair  on  the  scrotum,  the 


CASTRATION— ORCHECTOMY  273 

presence  of  a  dark,  thickened  pad  of  tissue,  and  the  increase 
in  the  size  of  the  scrotum. 

Fibroid  thickening  of  the  stroma  of  the  glands  is  observed 
as  a  sequel  to  orchitis  of  different  forms.  The  glands  have  lost 
their  normal  resiliency,  are  hard  and  non-sensitive.  After  a 
time  the  animal  becomes  impotent  and  the  glands  atrophic. 

(6)  Retention  cysts  are  found  occasionally  in  the  testicles 
of  the  cat  and  dog.  They  are  characterized  by  the  increase 
in  size  of  the  testicles,  and  by  their  soft,  elastic  feel.  A  small 
exploring  needle  can  be  used  to  determine  their  contents. 

(c)  Sarcomata  and  carcinomata  occur  occasionally  in  the 
testicles,  as  secondary  growths  from  other  parts  of  the  body. 
These  may  develop  as  unilateral  or  bilateral  tumors.  Most 
cases  observed  have  been  unilateral-.  They  are  characterized 
by  their  rapid  growth,  their  irregular  outline,  adhesions 
between  the  testicles  and  the  scrotum,  and  their  enormous 
size  in  some  cases.  They  are  always  accompanied  by  acute 
inflammatory  symptoms. 

Treatment.— Castration  is  the  best  means  of  relief,  even  in 
the  malignant  form. 

PARASITES  IN  THE  SCROTUM  AND  TESTES. 

Cuter ebra  Emasculator. 

In  some  localities  a  fly  (Cuterebra  emasculator)  has  been 
observed  which  makes  punctures  in  the  scrotum  in  which 
its  eggs  are  deposited.  The  larvae  develop  and  induce  a 
reactive  inflammation  which  leads  eventually  to  swelling 
and  destruction  of  the  testicles.  The  infestation  has  been 
observed  in  several  species  of  animal;  it  is  quite  common  in 
squirrels  in  certain  districts.  Castration  of  the  animal,  or  if 
found  early  the  removal  of  the  larva1,  is  recommended. 

CASTRATION.     ORCHECTOMY. 

In  the  dog  and  cat  castration  is  performed  in  some  cases 
to  relieve  pathological  conditions  of  the  testicles;  in  others 
as  a  remedial  measure  in  enlargement  of  the  prostate  gland 
(chronic  prostatitis).  It  has  been  proved  quite  conclusively 

18 


274      DISEASES  OF  THE  TESTES  AND  SCROTUM 

that  enlarged  prostates  in  the  dog  are  materially  reduced 
by  castration.  The  operation  is  also  quite  extensively 
practiced  in  cases  where  the  organs  are  normal,  but  to  correct 
vicious  habits  (onanism)  or  a  disposition  to  wander  away 
from  home. 

In  chickens  castration,  or  caponizing,  is  becoming  quite 
general  in  certain  sections.  It  not  only  changes  the  disposi- 
tion and  habits  of  the  birds,  but  makes  them  develop  more 
rapidly.  They  become  much  larger,  and  the  texture  of  the 
flesh  much  finer.  Hence  the  operation  is  of  considerable 
economic  importance. 

Castration  of  the  Dog.— The  operation  can  be  performed 
at  almost  any  age,  but  is  less  dangerous  before  the  dog  reaches 
maturity.  Between  the  ages  of  three  to  ten  months  the 
operation  is  safest  as  it  causes  less  constitutional  disturbance 
during  the  early  period  of  the  animal's  life.  The  disposition 
of  the  animal  is  changed  less,  and  there  is  not  the  tendency 
to  obesity  when  castration  is  performed  at  an  early  age. 
However,  when  pathological  conditions,  onanism,  etc.,  exist 
the  operation  may  be  performed  at  any  time. 

When  the  testicles  are  found  in  the  scrotum,  the  operation 
is  as  follows:  The  animal  is  anesthetized  by  using  morphin 
0.06-0.2  subcutaneously,  or  chloroform  inhalation.  Place 
the  patient  in  a  dorsal  position,  with  head  lowered,  and  hind 
limbs  spread  apart  on  the  table.  This  exposes  the  testicles 
and  makes  them  easy  of  access.  The  scrotum  should  be 
thoroughly  scrubbed  with  soap  and  water,  followed  by 
liberal  use  of  antiseptics.  The  testicles  are  grasped  between 
the  thumb  and  index  finger  of  the  left  hand  and  gentle  pres- 
sure used  to  make  the  scrotum  tense.  With  a  scalpel  or 
castrating  knife  in  the  right  hand,  an  incision  is  made  parallel 
to  the  long  axis  of  the  testicle,  cutting  through  the  tunica 
propia.  The  testicle  is  grasped  with  the  right  hand  which 
exposes  to  view  the  epididymis  and  tunica  reflexa.  There 
are  several  methods  used  to  remove  the  testicles.  The  cord 
may  be  ligated  above  the  epididymis  and  tunica  reflexa  by 
using  a  sterile,  silk  ligature  (No.  10).  This  is  a  safe  method, 
as  it  removes  the  possibility  of  hemorrhage,  provided  the 
ligature  is  securely  applied.  The  other  testicle  is  removed 


C ASTRA  TION—ORCHECTOM  Y  275 

in  the  same  manner.  The  emasculator  also  gives  excellent 
results.  The  instrument  should  be  allowed  to  remain  in 
position  for  a  few  moments  after  the  cord  is  severed.  Occa- 
sionally hemorrhage  will  follow  the  emasculator,  but  is 
usually  not  serious.  If  severe,  the  vessels  should  be  ligated. 
After  the  testicles  are  removed  the  wound  in  the  scrotum 
may  be  left  open,  or  a  retaining  suture  put  in  to  prevent  the 
entrance  of  foreign  material.  The  incisions  in  the  scrotum 
should  be  carried  forward  sufficiently  to  afford  thorough 
drainage.  The  scrotum  should  be  kept  clean  for  a  few  days, 
and  the  wound  washed  with  antiseptics.  Union  takes  place 
in  a  week  or  ten  days.  It  is  well  to  observe  the  animal,  note 
the  temperature  and  pulse  for  a  few  days,  and  if  the  tem- 
perature is  found  elevated,  examine  the  scrotal  wound  for 
retention  of  pus  and  secretions. 

Castration  of  the  Monorchid  and  Cryptorchid  Dog.— In 
monorchids  one  testicle  is  removed  the  same  as  in  ordinary 
castration.  The  retained  testicle  in  the  abdominal  cavity 
must  be  removed  by  making  an  incision  through  the  abdom- 
inal walls  about  two  to  four  inches  anterior  to  the  pubis,  and 
to  one  side  of  the  penis  (note  the  side  of  retention!).  The 
incision  is  made  large  enough  to  admit  the  index  finger  freely. 
The  cord  is  then  searched  for  in  the  sublumbar  region,  and 
when  found,  withdrawn  through  the  opening,  the  testicle 
following.  The  cord  may  be  ligated  or  the  operation  per- 
formed with  the  emasculator.  The  abdominal  wound  is 
approximated  with  two  or  three  interrupted  sutures.  An 
antiseptic  pack  and  bandage  should  be  applied  to  protect  the 
wound  and  changed  daily  until  healing  takes  place.  The 
bandage  is  applied  so  that  it  does  not  interfere  with  micturi- 
tion. Cryptorchids  are  operated  in  the  same  manner;  both 
testicles  may  be  removed  through  one  opening,  or  two 
abdominal  incisions  made  if  found  necessary.  The  patient 
should  be  properly  prepared  by  dieting  and  administering  a 
laxative  twenty-four  hours  before  the  operation. 

Castration  of  the  Cat.— The  same  rules  in  regard  to  age, 
etc.,  apply  as  in  the  dog.  Castration  of  the  cat  is  best  per- 
formed under  complete  anesthesia.  The  animal  is  placed 
on  the  table  in  the  dorsal  position,  well  hoppled  and  stretched 


276       DISEASES  OF  THE  TESTES  AND  SCROTUM 

out  so  that  it  cannot  squirm  loose.  Ether  is  administered 
until  complete  anesthesia  is  established.  The  hair  is  clipped 
off  with  a  scissors,  and  the  scrotum  washed  with  soap  and 
water  and  boric  acid  (2  per  cent.)  solution. 

The  testicles  are  grasped  between  the  thumb  and  index 
finger  of  the  left  hand,  and  with  the  other  hand  a  scalpel  is 
used  to  make  the  scrotal  incision.  Two  methods  of  removal 
are  used : 

The  first  method  is  to  make  the  incision  down  to  the 
testicle  exposing  it,  pulling  it  out  of  the  scrotal  sac,  and 
removing  it  with  the  emasculator  or  by  ligation.  Care  should 
be  taken  in  this  method  to  pull  the  testicle  up  far  enough  to 
include  the  epididymis  and  tunica  reflexa.  The  other  testicle 
may  be  removed  in  a  similar  manner. 

The  second  method  is  to  perform  the  "covered"  operation. 
This  is  done  in  much  the  same  manner  as  the  other  operation, 
except  that  the  incision  is  made  down  to  the  tunica  vaginalis 
which  is  not  incised  but  drawn  out  with  the  testicle.  The 
cord,  including  the  tunica  vaginalis,  is  then  ligated  above 
the  epididymis,  and  the  testicle  and  its  enveloping  tunic 
removed.  Hemorrhage  and  infection  are  not  so  liable  to 
follow  this  method. 

Castration  of  Birds.— Caponizing.—  Castration  is  com- 
monly practiced  on  male  fowls.  A  castrated  rooster  is  called 
a  capon.  The  best  results  are  obtained  by  operating  on  the 
early  hatched  birds  as  it  gives  them  more  time  for  develop- 
ment. Two  to  three  months  is  the  best  age  to  operate.  When 
the  bird  reaches  the  age  of  four  or  five  months  the  mortality 
is  much  higher  and  the  male  characteristics  more  pronounced. 

The  fowl  is  restrained  on  an  operating  table,  barrel,  or  box 
with  a  cord  looped  around  the  wing  and  one  around  the  legs, 
to  each  of  which  a  one  or  two  pound  weight  is  attached.  The 
bird  is  then  laid  on  its  right  side;  the  weights  serve  to  hold 
it  in  position.  Other  mechanical  devices  made  and  used  for 
this  purpose  have  proved  satisfactory.  The  instruments  for 
this  operation  are  made  up  in  special  sets  known  as  caponizing 
sets.  A  set  consists  of  a  scalpel  for  making  the  abdominal 
incision,  spreaders  or  retractors  for  keeping  the  abdominal 


CASTRATION— ORCHECTOM  Y  277 

wound  open,  and  a  special,  spoon-like  hook  for  removing  the 
testicles. 

The  technic  of  the  operation  is  as  follows:  The  feathers 
are  plucked  from  the  field  of  operation,  which  is  between  the 
last  two  ribs  extending  from  the  cartilage  of  prolongation  of 
the  ribs  to  a  point  about  one-half  to  one  and  a  half  inches  from 
the  back.  The  skin  over  this  region  should  be  disinfected, 
best  by  painting  with  tincture  of  iodin.  The  incision  is  then 
made  through  the  abdominal  wall  observing  the  following 
points: 

The  skin  should  be  pulled  to  one  side  before  the  incision  is 
made,  so  that  following  the  operation,  the  skin  and  deeper 
wounds  will  not  cover  one  another. 

The  incision  should  follow  closely  the  border  of  the  last 
rib  in  order  to  avoid  cutting  the  intercostal  artery,  ("are 
must  be  taken  to  avoid  injuring  the  cartilages  of  prolongation 
of  the  last  ribs.  Should  they  be  cut,  which  is  easily  done,  the 
healing  of  the  wound  will  be  delayed.  Further,  the  incision 
through  the  walls  should  be  made  carefully  to  avoid  punctur- 
ing the  lungs. 

After  the  retractors  are  placed  in  position,  and  the  incision 
dilated,  the  testicles  are  located  just  anterior  to  the  kidney. 
The  upper  one  will  be  found  without  difficulty;  the  lower  one 
is  brought  into  view  by  separating  the  mesentery  with  the 
handle  of  the  scalpel  or  other  blunt  instrument  immediately 
below  the  upper  testicle.  Remove  the  lower  testicle  first. 
The  spoon-hook  or  scoop  is  applied  around  the  testicle  by 
being  slipped  over  the  spermatic  cord.  Care  should  be  taken 
to  prevent  injury  to  the  large  bloodvessels.  The  testicle  is 
removed  by  torsion.  A  few  turns  of  the  instrument  will  sever 
the  testicle  from  its  attachments  when  it  can  be  lifted  out. 
The  other  testicle  is  then  removed  in  a  similar  mariner.  The 
entire  testicle  should  be  removed,  for  if  a  portion  is  left  in  the 
fowl  will  develop  into  what  is  commonly  known  as  a  "slip" 
and  the  object  of  the  operation  defeated.  After  the  spreaders 
or  retractors  are  removed  the  ribs  will  assume  their  normal 
position  closing  the  incision.  Xo  further  treatment  of  the 
wound  is  necessarv;  it  closes  without  difficulty  in  a  week  or 


278       DISEASES  OF  THE  TESTES  AND  SCROTUM 

ten  days.  The  operated  birds  must  be  kept  quiet  for  a  few 
days  following  the  operation,  and  fed  a  light  diet.  The  wound 
should  be  observed  occasionally  until  complete  union  takes 
place.  In  a  few  cases  collections  of  air  under  the  skin,  form- 
ing "wind  puffs,"  will  develop.  If  these  occur  they  are 
opened  and  the  air  forced  out.  The  mortality  from  caponiz- 
ing  should  not  exceed  1  per  cent. 


CHAPTER  III. 
DISEASES  OF  THE  PROSTATE  GLAND. 

Examination.— In  the  dog  this  gland  is  best  examined  by 
digital  palpation,  and  in  some  cases,  when  the  gland  is  much 
enlarged,  by  palpation  through  the  abdominal  walls.  The 
finger  is  inserted  in  the  rectum  and  if  any  enlargements  are 
present  they  can  be  distinctly  felt  by  pressing  in  a  downward 
direction;  if  acute  inflammation  is  present  the  slightest 
pressure  will  produce  severe  pain. 

PROSTATITIS. 

Definition.  —An  acute  or  chronic  inflammation  of  the  pros- 
tate gland.  In  the  dog  this  disease  is  nearly  always  found  to 
be  of  a  subacute  or  chronic  type.  Acute  prostatitis  is  very 
rare  in  these  animals. 

Etiology.— Prostatitis  is  produced  by  microbic  invasion, 
either  via  the  urinary  tract,  the  blood  or  lymph  streams.  It 
may  occur  from  the  spread  of  the  inflammation  from  other 
portions  of  the  urinary  tract. 

Symptoms.— Prostatitis  usually  develops  gradually.  The 
early  symptoms  are  painful  defecation  and  micturition. 
The  animal  will  make  frequent  attempts  at  urinating,  the 
urine  voided  in  small  quantities,  or  there  may  be  complete 
suppression.  Defecation  is  painful;  sometimes  impossible. 
The  bladder  is  found  distended.  The  passage  of  the  catheter 
is  often  difficult  due  to  the  pressure  of  the  enlarged  glands 
upon  the  urethra.  Gentle  pressure  on  the  catheter  will  cause 
pain,  but  in  most  cases  it  will  gradually  pass  through  the 
constricted  portion  into  the  bladder.  The  urine  will  then 
flow  out. 

Digital  examination  with  the  index  finger  inserted  in  the 
rectum  will  reveal  the  enlarged  glands.  Should  pus  be  present 
in  the  glands  they  will  be  somewhat  soft  and  fluctuating. 


280  DISEASES  OF  THE  PROSTATE  GLAND 

The  abscesses  sometimes  rupture,  either  into  the  urethra, 
the  abdominal  cavity  or  through  the  skin  in  the  perineal 
region. 

More  or  less  irregularity  in  the  temperature  is  noted. 

Prognosis.— Although  complete  recovery  cannot  be  hoped 
for,  owing  to  the  changes  which  have  taken  place  in  the 
glands,  partial  recovery  is  possible. 

Treatment. — M edical.— Purgatives  should  be  administered 
at  once,  such  as  castor  oil  (15.0-30.0)  or  magnesium  sulphate 
(8.0-15.0).  Small  doses  of  morphin  may  be  given  in  case 
pain  is  severe. 

Surgical.— The  bladder  is  examined  and  if  found  distended, 
the  catheter  should  be  passed  and  the  urine  withdrawn.  If 
this  is  impossible,  on  account  of  the  compression  of  the 
urethra,  immediate  puncture  of  the  bladder  with  a  trocar 
may  be  made.  The  prostate  gland  must  be  examined  care- 
fully, and  if  found  fluctuated,  indicating  abscess  formation, 
make  an  attempt  to  relieve  it  by  pressure  with  the  finger 
inserted  into  the  rectum.  This  method  is  often  satisfactory. 
Should  this  fail,  a  long  exploring  trocar  is  introduced  into 
the  gland  either  through  the  rectal  wall  or  through  the  peri- 
neum. In  either  case  the  finger  should  be  retained  in  the 
rectum  to  guide  the  insertion  of  the  trocar,  and  also  to  exert 
some  pressure  on  the  gland  to  force  the  contents  out.  Pros- 
tatic  abscesses  are  sometimes  found  with  an  opening  out 
through  the  perineum.  The  opening  should  be  enlarged 
sufficiently  to  afford  good  drainage,  and  syringed  out  with 
an  antiseptic  solution.  Rupture  of  the  abscess  into  the  peri- 
toneal cavity  results  in  peritonitis,  and  death  in  a  short  time. 

TUMORS  OF  THE  PROSTATE  GLAND. 

Hypertrophy  of  the  Prostate  Gland. 

Hypertrophy  is  common  in  old  dogs,  and  is  occasionally 
observed  in  young  animals.  In  hypertrophy,  the  normal 
glandular  tissue  is  gradually  replaced  by  fibrous  connective 
tissue,  which  leads  to  an  atrophy  of  the  tubules  and  muscle 
fibers  greatly  increasing  in  the  stroma  of  the  gland.  The 
gland  gradually  loses  its  function  of  secretion,  becomes  much 


TUMORS  OF   THE  PROSTATE  (1LAXD  2X1 

larger,  and  firmer  than  normal.  In  the  dog  the  prostate 
gland  lies  at  the  neck  of  the  bladder,  almost  surrounding  the 
urethra,  and  when  hypertrophied  it  causes  compression  of 
the  urethra  making  the  passage  of  urine  difficult. 

Symptoms.— The  most  pronounced  symptoms  of  hyper- 
trophy of  the  prostate  gland  are:  Obstruction  to  the  passage 
of  urine.  The  animal  makes  frequent  attempts  to  urinate 
but  either  only  a  small  quantity  or  none  at  all  is  passed.  The 
straining  induced  may  cause  hematuria.  The  hemorrhage 
results  from  the  pressure  on  the  venous  plexus  of  the  gland 
exerted  by  the  hypertrophic  tissue.  The  bladder  will  be 
found  distended  and  the  animal  showing  considerable  dis- 
tress. There  is  always  danger  of  rupture  of  the  bladder  from 
overdistention.  A  complication  of  conditions  is  often  found 
'  in  these  cases  of  long  standing,  such  as  hydronephrosis, 
cystitis,  etc.  Constipation  is  practically  a  constant  symptom 
owing  to  the  interference  with  defecation.  Xo  febrile  symp- 
toms are  observed  in  hypertrophy  of  the.  gland.  Passing  the 
catheter  will  reveal  the  urethral  obstruction.  This  may  be 
so  pronounced  that  it  will  be  impossible  to  get  the  catheter 
beyond  the  prostate.  It  is  possible  to  palpate  the  enlarged 
gland  by  inserting  the  finger  in  the  rectum,  or  in  very  thin 
subjects  the  gland  may  be  felt  through  the  abdominal  walls. 

Diagnosis. — The  diagnosis  is  made  by  observing  the  symp- 
toms, passing  the  catheter,  and  digital  palpation.  We  must 
differentiate  hypertrophy  from  abscess  and  inflammation  of 
the  gland.  The  difference  in  the  temperature,  the  age  of  the 
animal,  the  size  and  consistency  of  the  gland,  and  the  ehron- 
icity  of  the  process  are  indicative. 

Prognosis. —The  prognosis  is  unfavorable. 

Treatment.— The  bladder  should  be  examined,  and  it' 
found  distended,  emptied  either  by  passing  the  catheter  or 
by  the  use  of  the  trocar. 

Laxatives  should  be  given  (see  Inflammation  of  the  Pros- 
tate Gland).  Internal  administration  of  potassium  iodid 
(0.1-0.2)  daily  has  been  used  with  success  in  some  cases. 
At  the  same  time  injections  of  Lugol's  solution  directly  into 
the  gland  may  be  employed.  The  injection  is  made  with  a 
small  calibered,  hypodermic  needle,  which  is  inserted  into  the 


282  DISEASES  OF  THE  PROSTATE  GLAND 

gland,  either  through  the  rectum  or  perineal  region,  the 
syringe  attached  and  the  injection  made.  Two  to  four  c.c. 
of  the  solution  are  sufficient. 

Castration  is  distinctly  remedial  as  it  is  followed  by  a 
reduction  in  the  size  of  the  gland.  Obviously  it  cannot  be 
employed  in  stud  dogs.  (See  Castration.)  Experimentally  it 
has  been  proved  that  in  a  short  time  following  castration 
the  gland  begins  to  atrophy.  The  activity  and  function  of 
this  gland  depends  to  a  large  extent  upon  the  function  of 
the  testicles.  Some  few  cases  have  been  successfully  treated 
by  castration. 

Sarcomata  and  carcinomata  have  been  found  in  this 
gland,  but  are  not  common.  When  found,  no  treatment  can 
be  given. 


CHAPTER   IV. 
DISEASES  OF  THE  OVARIES. 

Examination.— Several  methods  of  examination  are  used 
to  detect  abnormal  and  pathological  conditions  of  the  ovaries. 

(a)  By  abdominal  palpation.  This  method  has  not  proved 
very  satisfactory  on  account  of  the  small  size  of  the  ovaries, 
and  the  amount  of  tissue  necessary  to  palpate  through.  In 
emaciated  subjects  or  when  glands  are  enlarged,  palpation 
is  useful.  In  cats  with  large  ovarian  cysts,  the  cysts  may  be 
felt  through  the  abdominal  walls.  For  abdominal  palpation 
the  animal  is  placed  in  a  standing  position.  The  manipulator 
should  stand  either  immediately  in  front  of  or  in  the  rear  of 
the  animal  with  one  hand  on  either  side  of  the  abdomen;  the 
ovaries  may  be  felt  in  the  sublumbar  region.  This  method 
is  of  value  in  a  general  way,  but  for  accurate  diagnosis  it 
does  not  suffice. 

(6)  By  observing  the  animal  to  note  any  symptoms  of 
excitement,  etc.  Cats  with  ovarian  cysts  will  often  show 
evidences  of  nervous  excitement,  epileptiform  convulsions, 
etc. 

(c)  Direct  inspection  of  the  ovaries  can  be  made  with  but 
very  little  danger.  Therefore  in  doubtful  cases  laparotomy 
should  be  performed  and  the  ovaries  examined  for  inflamma- 
tion, tumors,  cysts,  etc. 

INFLAMMATION  OF  THE  OVARIES. 

Oophoritis. 

Definition.— An  acute  or  chronic  inflammation  of  one  or 
both  ovaries.  Oophoritis  is  not  observed  very  often  in 
animals.  It  should  not  be  mistaken  for  the  normal  hyperemia 
of  the  glands  during  the  estral  period.  However,  acute  and 
chronic  inflammations  are  found  involving  these  glands. 


284  DISEASES  OF  THE  OVARIES 

Etiology.— Results  from  injuries,  such  as  being  run  over 
by  vehicles.  The  compression  of  the  organs  may  be  suffi- 
cient to  crush  them,  or  it  may  lead  to  inflammation. 

Extension  of  the  inflammation  from  adjacent  organs  and 
tissues,  as  from  the  uterus  and  uterine  tubes. 

Infection  of  the  ovaries  may  take  place  in  some  of  the 
infectious  diseases  (distemper  in  the  dog  and  cat),  or  it  may 
be  due  to  some"  non-specific  infection  carried  to  the  ovaries 
by  the  circulatory  system. 

Symptoms.— In  dogs  oophoritis  may  not  be  noticed.  The 
patient  will  show  stiffness  in  walking  and  pain  on  palpation 
over  the  glands.  In  cases  where  infection  has  taken  place 
in  the  glands,  abscesses  may  develop,  and  febrile  symptoms 
be  present.  In  subacute  or  chronic  inflammations  no  marked 
symptoms  will  be  observed  beyond  an  enlargement  of  the 
glands.  In  cats  epileptiform  convulsions  may  result. 

Diagnosis.— In  the  mild  forms  an  accurate  diagnosis  is 
difficult  without  making  an  explorative  laparotomy.  In 
cats  it  should  be  differentiated  from  ovarian  cysts.  A  careful 
examination  must  be  made  in  all  cases. 

Prognosis.— Favorable,  except  when  produced  by  infection. 
In  the  chronic  form  sterility  is  a  common  sequel. 

Treatment.— Not  much  treatment  is  needed.  In  the  severe 
forms,  or  when  abscesses  are  present,  it  is  advisable  to  remove 
the  ovaries  (oophorectomy). 


TUMORS  OF  THE  OVARIES. 

Cysts.— Cystic  formation  in  the  ovaries  is  of  very  frequent 
occurrence,  and  perhaps  much  more  common  in  cats  than 
in  any  of  the  other  animals.  They  consist  in  most  instances 
of  unruptured  Graafian  follicles,  and  are  found  either  single  or 
multiple.  Unless  they  are  of  considerable  size  they  do  not 
produce  any  marked  symptoms.  In  fact,  where  they  are  fre- 
quently found  as  multiple  cysts,  and  when  degeneration  of 
the  ovary  has  taken  place,  marked  nervous  symptoms  will 
be  noted.  These  are  excitement,  prolonged  estrum,  and  in 
some  instances  epileptiform  convulsions. 


OOPHORECTOMY—OVARIECTOMY  285 

Diagnosis. —The  diagnosis  is  difficult  in  most  cases.  Unless 
the  cysts  are  of  large  size,  and  the  nervous  symptoms  marked, 
the  condition  is  usually  not  suspected.  Laparotomy  should 
be  performed  and  the  ovaries  inspected  to  make  the  diagnosis 
positive.  The  cysts  appear  as  enlargements  projecting  from 
the  ovary.  Their  consistency  is  fluctuating;  their  contents 
transparent. 

Prognosis.— The  prognosis  is  unfavorable  so  far  as  relieving 
the  condition  and  preserving  the  ovary  are  concerned.  The 
symptoms  can  be  relieved  by  removal  of  the  glands. 

Treatment. — The  treatment  is  surgical  and  consists  of  the 
removal  of  the  diseased  gland.  (See  Ovariectomy.) 

Other  tumor  formations  in  the  ovaries  are  uncommon. 
Dermoid  cysts  have  been  found  in  a  few  instances.  Adenoma 
and  adenocarcinoma  occur  as  secondary  growths.  When 
found  the  entire  gland  or  glands  should  be  extirpated. 

OOPHORECTOMY.     OVARIECTOMY. 

Oophorectomy  is  extensively  practiced  to  correct  certain 
pathological  conditions  which  are  found  in  the  ovaries  to 
suppress  the  sexual  desire  and  prevent  the  female  from  becom- 
ing pregnant,  and  to  make  more  desirable  house  dogs  and 
pets  as  they  are  more  contented  and  peaceful.  Cats,  when 
operated  during  the  first  few  months  of  their  life,  become 
much  larger,  and  are  much  more  desirable  animals  to  have 
about  the  house. 

All  female  animals  should  be  operated  if  possible  before 
the  advent  of  the  first  estrual  period,  as  it  has  been  proved  by 
experience  that  some  females  will  continue  to  show  sexual 
desire  following  complete  removal  of  the  glands.  Such  cases 
are  observed  in  older  females,  especially  those  that  have  given 
birth  to  young,  and  these  that  have  estruated  normally  for 
some  time.  However,  we  must  take  into  consideration  that 
in  a  number  of  cases  where  estruation  follows  removal  of  the 
glands,  is  due  to  the  fact  that  a  small  portion  of  the  ovarian 
tissue  has  been  left  in,  which  develops  and  frequently  becomes 
cystic. 

The  effect  of  this  operation  on  females  is  worthy  of  note. 


286  DISEASES  OF  THE  OVARIES 

Young  animals  operated  before  the  periods  of  estrum  are 
present,  show  no  appreciable  change  in  their  development. 
They  are  active,  develop  regularly,  and  in  every  way  make 
very  desirable  animals.  The  most  marked  change  occurs 
when  older  animals  are  operated.  They  often  become  fat, 
lazy,  and  inactive.  Certain  breeds  of  animals  show  these 
changed  characteristics  more  than  others.  For  this  reason 
the  operation  should  be  performed  before  the  animal  reaches 
sexual  maturity. 

Oophorectomy  in  the  Dog.— This  is  one  of  the  most  fre- 
quent operations  performed  on  dogs.  It  is  a  safe  operation 
provided  the  following  precautions  are  taken  into  considera- 
tion :  (a)  The  operation  should  be  performed  when  the  dog 
is  about  three  to  five  months  old,  and  before  it  has  had  an 
estrual  period.  (6)  The  animal  should  not  be  operated  during 
estruation,  notwithstanding  the  prevailing  belief  of  the  laity 
to  the  contrary.  As  the  ovaries  and  other  portions  of  the 
generative  tract  are  congested  at  this  time,  the  danger  of 
hemorrhage  and  inflammation  is  greater.  One  should  wait 
two  or  three  weeks  after  the  period  of  estruation  so  that  the 
organs  can  return  to  their  normal  condition,  (c)  The  prep- 
aration of  the  animal  before  operating  is  of  special  impor- 
tance. The  bowels  should  be  empty.  For  this  purpose  castor 
oil  (15.0-60.0)  should  be  administered  twenty-four  hours 
previous  to  the  operation.  All  solid  food  is  withheld,  but 
small  amounts  of  milk  and  water  only  may  be  allowed.  The 
field  of  operation  should  be  prepared  twenty-four  hours  pre- 
viously; the  hair  removed,  the  skin  washed  with  soap  and 
water,  and  an  antiseptic  pack  applied.  This  pack  is  best 
made  of  cotton  of  gauze  with  boric  acid;  it  is  applied  to  the 
operating  field  and  held  in  place  by  a  special  bandage  made 
of  a  wide  piece  of  muslin  so  as  to  extend  from  in  front  of  the 
forelimbs  to  a  point  back  of  the  field  of  operation,  and  tied 
over  the  back.  This  pack  should  be  kept  in  position  until 
the  animal  is  ready  for  the  operation.  This  will  ensure  a 
sterile  operating  field.  As  a  last  precautionary  measure, 
just  previous  to  making  the  incision,  the  operating  field  is 
painted  with  tincture  of  iodin.  An  anesthetic  or  narcotic 
should  be  given.  In  the  dog  various  methods  of  anesthetiza- 


OOPHORECTOMY—OVARIECTOMY  287 

tion  and  narcotization  have  been  employed  with  equally 
good  results.  Morphin  given  as  a  subcutaneous  injection 
about  twenty  to  thirty  minutes  previous  to  the  operation 
has  been  used  with  most  excellent  results.  The  value  in  this 
method  of  narcotization  lies  in  the  fact  that  it  will  cause 
vomiting  in  most  cases,  defecation  in  some,  removing  mate- 
rial from  the  stomach  and  bowels.  Further,  it  will  keep  the 
animal  quiet  for  several  hours  following  the  operation.  It 
may  be  considered  a  perfectly  safe  narcotic,  which  to  dogs 
can  be  administered  in  large  doses.  The  amount  to  be 
administered  will  depend  to  a  great  extent  upon  the  size  of 
the  animal.  Usually  from  0.016-0.2  are  to  be  given. 

Chloroform  and  ether  may  be  used  as  a  general  anesthetic; 
both  are  safe  when  administered  properly.  After  anesthe- 
tization the  animal  should  be  placed  in  a  dorsal  position,  well 
hoppled  and  the  table  tilted  to  lower  the  head  as  much  as 
possible.  This  assists  the  operator,  as  the  bowels  will  descend 
toward  the  diaphragm  which  lessens  the  tendency  for  them 
to  protrude  through  the  incision.  The  incision  may  be  made 
either  at  the  median  line  or  in  the  flank  region.  There  are 
good  reasons  for  choosing  the  median  incision.  There  is  less 
hemorrhage  at  this  location,  it  is  much  easier  to  locate  the 
cornua  and  the  removal  of  both  ovaries  through  one  opening 
can  be  done  with  less  difficulty.  The  exact  location  for  the 
incision  in  the  median  line  is  at  a  point  about  one  to  one  and 
a  half  inches  posterior  to  the  umbilicus.  The  incision  should 
be  made  of  sufficient  length  to  allow  the  index  finger  to  be 
inserted,  or  it  may  be  enlarged  so  that  light  can  be  thrown 
into  the  abdominal  cavity.  The  incision  is  made  through 
the  skin,  separating  the  muscles  down  to  the  peritoneum. 
In  making  the  incision  through  the  peritoneum  it  is  best  to 
pick  up  a  small  portion  of  it  with  a  forceps,  nick  with  the 
scissors  and  enlarge  with  a  probe-pointed  knife.  By  this 
procedure  injury  to  the  bladder  or  other  abdominal  organs 
is  avoided.  The  index  finger  of  the  right  hand  is  then  inserted 
through  the  opening;  follow  the  left  abdominal  wall  pushing 
the  bowels  back  until  the  finger  reaches  the  bottom  of  the 
cavity.  At  this  point  the  finger  will  come  in  contact  with  the 
left  cornu,  which  is  hooked  over  the  finger  and  drawn  out  of 


288  DISEASES  OF  THE  OVARIES 

the  cavity.  Be  careful  to  keep  the  finger  in  constant  contact 
with  the  abdominal  wall  so  that  the  cornu  will  not  slip  off. 
When  once  outside  of  the  cavity  the  ovary  can  be  located 
easily  by  following  the  course  of  the  cornu.  The  ovary  is 
distinguished  by  its  consistency.  In  most  cases  in  the  dog 
it  will  be  found  imbedded  in  a  capsule  of  fat.  There  are  two 
methods  of  removing  the  ovary,  and  the  choice  of  them  will 
depend  somewhat  upon  the  condition  of  the  gland.  In  young 
females,  before  the  ovaries  have  fully  matured,  and  in  older 
ones  between  the  periods  of  estrum,  it  is  safe  to  remove 
them  with  an  emasculator,  unless  considerable  congestion  is 
present.  Where  there  is  danger  of  hemorrhage,  the  ligation 
method  is  used.  When  this  method  is  employed,  sterile  silk 
or  linen  is  best  which  should  be  put  on  securely  so  that  it  will 
not  slip  off  after  removing  the  ovary.  Ligation  should  be 
made  at  two  points,  around  the  cornu  posterior  to  the  ovary, 
and  around  the  vessels  and  the  broad  ligament  anterior  to 
the  ovary,  ("are  must  be  taken  that  all  of  the  ovarian  tissue 
is  removed.  Otherwise  the  females  will  again  estruate,  and 
the  success  of  the  operation  will  be  incomplete.  \Vhen 
removing  the  gland  with  the  emasculator  it  must  be  pulled 
up  sufficiently  so  that  it  will  include  all  of  the  ovarian  tissue. 
It  is  best  to  allow  the  instrument  to  remain  in  position  a  few 
moments.  The  cornu  is  then  returned  to  the  cavity.  The 
other  ovary  is  obtained  by  inserting  the  index  finger  of  the 
left  hand  and  following  along  the  right  abdominal  wall  as 
was  done  on  the  opposite  side. 

The  location  of  the  ovaries  is  not  difficult  when  the  animal 
is  properly  prepared.  Small,  fat  patients,  with  a  short  abdom- 
inal cavity,  will  present  the  greatest  difficulties.  The  intro- 
duction of  a  probe  or  catheter  through  the  vagina  may  be 
used  by  the  beginner. 

The  abdominal  incision  is  cleansed  thoroughly  and  approxi- 
mated by  using  two  or  more  interrupted  sutures.  Suturing 
the  abdominal  walls  may  be  done  by  using  two  rows  of  sutures 
one  row  including  the  peritoneum,  and  the  other  the  skin  and 
muscles,  or  may  be  closed  by  a  single  row  including  all  of  the 
tissues.  This  method  has  proved  satisfactory.  The  abdom- 
inal walls  should  be  accurately  approximated  as  it  facilitates 
adhesions  and  healing. 


POULARDIZING  THE  FEMALE  CHICKEN          289 

An  antiseptic  pack  is  applied  and  the  regular  bandage 
used  to  hold  it  in  place.  Dress  the  wound  daily  and  in  four 
to  six  days  the  sutures  may  be  removed. 

Sometimes  animals  are  observed  to  estruate  following 
this  operation,  and  in  such  cases  they  should  be  reoperated, 
as  it  results  in  most  instances  from  a  small  amount  of  ovarian 
tissue  being  left  in.  Cysts  will  form  in  such  cases  leading 
to  a  continuance  of  the  estrual  period. 

Oophorectomy  in  the  Cat.— Cats  are  operated  to  correct 
pathological  conditions,  particularly  cystic  formations  in  the 
ovaries,  which  are  very  common  in  these  animals,  and  also 
to  prevent  them  from  becoming  pregnant.  They  should  be 
operated  if  possible  prior  to  sexual  maturity,  and  the  best 
time  is  between  the  ages  of  three  and  seven  months. 

The  same  preparation  should  be  made  for  the  cat  as  in  the 
dog.  The  most  satisfactory  anesthetic  is  ether.  The  opera- 
tive technic  is  the  same  as  in  the  dog.  It  has  been  claimed 
that  this  operation  is  more  dangerous  in  the  cat  than  in  other 
animals,  but  when  done  under  proper  conditions  the  mortality 
is  very  low. 

POULARDIZING  THE  FEMALE  CHICKEN. 

This  operation  is  performed  on  the  female  fowl  to  prevent 
egg  formation,  and  to  ensure  quick  growth  and  a  finer  quality 
of  meat.  The  operation  is  not  practiced  as  extensively  in 
this  country  as  in  some  of  the  European  countries.  Undoubt- 
edly, however,  the  operation  will  become  more  popular  than 
at  present. 

The  best  age  to  operate  is  after  two  to  three  months.  The 
same  preparation  should  be  made  as  in  caponizing.  (See 
Caponizing.) 

The  operation  is  performed  as  follows:  Securely  fasten 
the  bird  on  a  table  or  other  suitable  place,  and  remove  the 
feathers  from  the  field  of  operation,  which  is  between  the 
last  two  ribs.  Thoroughly  cleanse  and  disinfect.  The 
incision  is  made  between  the  last  two  ribs,  using  the  same 
precautions  as  in  caponi/ing.  Retractors  are  used  to  spread 
the  incision.  The  egg  cluster  will  come  into  view  at  once. 
ID 


290  DISEASES  OF  THE  OVARIES 

A  section  of  about  one  to  .one  and  a  half  inches  of  the  oviduct 
should  be  removed  with  the  forceps  and  scissors.  Care  must 
be  taken  to  prevent  injury  to  the  large  bloodvessels  which 
lie  in  close  proximity  to  the  egg  cluster.  The  removal  of  a 
portion  of  the  oviduct  prevents  further  egg  production. 
After-treatment  is  the  same  as  for  caponizing. 


CHAPTER   V. 
DISEASES  OF  THE  UTERINE  TUBES. 

Examination.— Examination  of  the  uterine  tubes  is  quite 
difficult,  except  by  explorative  laparotomy.  They  should 
be  examined  for  inflammation,  tumors,  cysts,  and  pus  accu- 
mulations. In  some  cases,  when  the  animal  is  much  emaci- 
ated, and  the  tubes  large,  it  is  possible  to  palpate  them 
through  the  abdominal  wall. 

SALPINGITIS. 

Definition.  — Inflammation  of  the  uterine  tubes. 

Etiology.— Salpingitis  occurs  as  a  secondary  condition 
following  inflammation  of  other  portions  of  the  generative 
apparatus. 

Symptoms. — The  diagnosis  is  difficult  unless  laparotomy 
is  resorted  to.  Other  reproductive  organs  are  usually  also 
involved  complicating  the  symptoms. 

Treatment.— Very  little  can  be  done  except  complete  extir- 
pation of  the  affected  tubes. 

PYOSALPINX. 

Pyosalpinx  is  a  purulent  inflammation  of  the  uterine  tubes. 
It  is  secondary  to  other  diseases  of  the  reproductive  organs. 
Removal  of  the  uterine  tubes  is  recommended. 

TUMORS.     CYSTS. 

These  are  found  occasionally  and  when  present  should 
be  extirpated. 


CHAPTER  VI. 
DISEASES  OF  THE  UTERUS. 

Examination.— There  are  three  principal  ways  in  which 
an  examination  of  the  uterus  may  be  made :  (a)  By  abdom- 
inal palpation;  (6)  by  obtaining  the  discharge  from  the  uterus 
and  noting  the  condition  of  the  vulva  and  vagina;  (c)  by 
laparotomy. 

(a)  In  abdominal  palpation  it  is  possible  to  determine 
various  conditions  involving  the  uterus.  The  patient  should 
be  placed  in  a  standing  position.  With  one  hand  on  either 
side  of  it  over  the  postero-inferior  abdominal  region,  the 
operator  by  gentle  pressure  with  the  finger  can  feel  the 
uterus  when  distended,  as  an  elongated,  suspended  body,, 
within  the  abdominal  cavity.  Palpation  may  be  used  to 
detect  pregnancy,  pyometra,  hydrometra,  tumors  and  inflam- 
mation. Sometimes  in  order  to  differentiate  between  these 
conditions  it  is  necessary  to  make  a  general  examination  of 
the  animal. 

(6)  In  some  of  the  conditions  involving  the  uterus,  there 
is  a  discharge  from  the  vulva.  The  discharge  should  be 
collected  and  examined  carefully,  noting  whether  or  not  it 
consists  of  blood,  mucus,  pus,  membranes,  bacteria,  etc. 
The  microscope  may  be  employed  if  necessary. 

(c)  By  laparotomy  it  is  possible  to  make  a  direct  inspec- 
tion of  the  uterus.  It  is  advisable  when  there  is  evidence  of 
serious  involvement  of  the  organ,  and  where  the  diagnosis 
is  in  doubt.  The  incision  through  the  abdominal  walls  is 
made  in  the  median  line  just  anterior  to  the  pubis,  extend- 
ing forward  a  sufficient  distance  to  allow  the  uterus  to  be 
drawn  out.  The  uterus  may  be  enlarged.  The  external  or 
serous  covering  should  be  observed  for  evidences  of  inflam- 
mation, hemorrhage,  and  rents  or  tears  in  the  walls,  Note 


METRITIS  293 

the  relative  size  of  the  two  cornua,  as  compared  to  the  size 
of  the  body  of  the  uterus,  their  position  and  attachments. 
Tumors,  pregnancy,  etc.,  should  be  looked  for.  The  con- 
sistency of  the  organ  is  important  as  it  is  modified  by  the 
character  of  its  contents,  whether  fluid,  or  solid  material. 
The  entire  organ  should  be  carefully  palpated  for  differential 
diagnosis  between  pregnancy,  tumors,  proliferative  or  fibroid 
endometritis,  pyometra,  hydrometra,  etc.  After  a  careful 
examination  the  uterus  may  be  returned  to  the  cavity  or 
operated  as  the  condition  indicates. 

METRITIS. 

Definition.— An  inflammation  of  the  uterus  which  may  be 
(«)  acute,  or  (6)  chronic. 

Acute  Metritis.—  Definition.— An  acute  inflammation  of  the 
uterus.  In  most  instances  it  is  to  be  regarded  as  an  acute 
inflammation  of  the  mucosa  (acute  endometritis).  In  some 
cases  the  musculature  and  serous  coverings  are  involved 
(metroperitonitis) . 

Etiology.— Metritis  is  a  condition  in  which  infection  of 
various  kinds  is  found  to  be  the  primary  etiologies!  factor. 
There  are  various  conditions  which  occur  in  small  animals 
that  favor  uterine  infection  and  ultimately  lead  to  an  acute 
inflammation.  These  are:  (a)  The  retention  of  the  fetal 
envelopes.  If  not  expelled  after  the  normal  time  has  elapsed 
they  constitute  a  source  of  danger  to  the  animal,  as  they 
form  a  favorable  medium  for  the  growth  of  bacteria.  The 
retained  membranes  keep  the  cervix  of  the  uterus  open, 
which  favors  the  introduction  of  bacteria,  and  interferes  with 
the  normal  involution  of  the  organ.  Retained  placenta  is 
not  so  common  in  small  animals  as  the  membranes  are 
usually  passed  with  the  fetus. 

(6)  Infection  is  introduced  into  the  uterus  at  the  time  of 
parturition  by  the  use  of  infected  instruments  or  ringers 
used  in  cases  of  dystocia. 

(c)  Wounds  of  the  mucosa  of  the  vagina  and  uterus 
greatly  facilitate  the  entrance  of  infection.  Depending  upon 
their  depth,  wounds  may  lead  to  metroperitonitis. 


294  DISEASES  OF  THE   UTERUS 

(d)  The  retention  of  a  fetus  or  fetuses  which  decompose, 
irritate  the  mucosa,  and,  if  allowed  to  remain  for  a  long  period, 
often  produce  grave  symptoms  of  local  inflammation  and 
sapremia.     In  some  cases  the  uterine  mucosa  is  greatly 
changed  by  the  infection.     The  uterus  may  be  converted 
into  a  cavity  filled  with  pus  (pyometra) . 

(e)  Slowness  in  the  involution  of  the  uterus  from  lack  of 
muscular  tone  favors  the  introduction  and  development  of 
infection.    For  the  same  reason  individuals  weakened  from 
delayed  parturition,  systemic  diseases,  etc.,  are  predisposed. 

(/)  In  bitches  and  cats  that  are  kept  in  cold,  damp  kennels, 
metritis  is  occasionally  observed,  and  no  doubt  results  from 
the  general  reduction  in  resistance,  and  from  the  weakened 
condition  of  the  highly  sensitive  reproductive  organs.  This 
favors  the  development  of  microorganisms. 

(g)  In  small  animals  injuries  of  various  sorts  are  common, 
such  as  being  kicked,  run  over  by  vehicles,  or  roughly 
handled  by  persons,  especially  during  the  latter  stages  of 
pregnancy.  The  uterus  may  be  injured,  sometimes  torn  or 
lacerated,  and  inflammation  with  infection  is  the  common 
sequel. 

Pathology.— In  fatal  cases  of  acute  metritis,  marked  patho- 
logical changes  are  observed  in  the  generative  tract,  and  par- 
ticularly in  the  uterus.  The  uterus  is  dark  colored,  in  some 
cases  almost  black,  the  mucosa  showing  necrotic  areas.  In 
some  instances  the  necrosis  extends  to  the  other  tissues  of 
the  walls  of  the  uterus  causing  perforations.  The  walls  of 
the  uterus  are  thickened,  edematous;  the  serous  covering 
is  often  inflamed  as  are  the  adjacent  organs  and  tissues  in 
contact  with  it.  Occasionally  abscesses  are  found  in  the 
uterine  walls,  or  in  the  surrounding  tissues.  In  the  virulent 
cases  of  metritis  there  will  be  found  evidences  of  thrombosis 
of  the  bloodvessels  of  the  uterus,  leading  to  embolisms  in  the 
vessels  in  distant  parts  of  the  body,  producing  in  some  cases 
pyemic  arthritis,  etc.  The  vulva  and  vagina  are  swollen  and 
necrotic,  and  a  greenish  colored  exudate  of  offensive  odor  is 
present.  The  other  organs  and  tissues  will  show  the  usual 
postmortem  lesions  of  septicemia  or  pyemia.  The  blood  is 
dark  colored  and  fails  to  coagulate.  The  kidneys  and  liver 


METRITIS  295 

are  soft  and  congested.  The  musculature  in  general  is  pale, 
friable  and  soft. 

Symptoms.— The  first  indication  of  metritis  is  a  marked 
swelling  and  congestion  of  the  vulva.  On(digital  examination 
the  parts  will  be  found  sensitive,  very  hot,  and  present  on  the 
mucosa  a  greenish  or  brown  or  blood-stained  discharge  which 
has  a  very  fetid  odor. 

The  vagina  is  swollen,  very  hot,  and  in  the  early  stages, 
reddened  and  congested.  Later  it  becomes  dark  or  dark 
bluish,  and  in  some  cases  almost  black  in  color,  with  a  foul 
smelling  exudate.  This  discharge  is  more  copious  at  times, 
as  it  is  forced  out  of  the  uterus  at  different  intervals. 

Frequently  the  animal  shows  marked  symptoms  of  strain- 
ing, the  abdominal  muscles  become  tense,  and  quantities 
of  a  thick,  dark  colored  exudate  are  discharged  from  the 
vulva. 

The  temperature  during  the  early  stages  is  elevated 
(106°  F.).  Later,  as  the  toxins  are  absorbed,  the  tempera- 
ture drops  to  normal,  often  subnormal. 

There  are  general  symptoms  of  suppression  of  appetite, 
vomiting,  general  stiffness  in  walking  and  pain  on  palpation 
over  the  region  of  the  uterus.  The  animal  in  most  instances 
assumes  the  recumbent  position. 

In  mild  cases  the  symptoms  will  gradually  disappear  and 
terminate  in  complete  recovery,  or  in  chronic  metritis. 

Diagnosis.— The  condition  appearing  as  it  does  following 
parturition,  with  the  characteristic  discharge  from  the  vulva, 
and  the  painful  and  sensitive  condition  of  the  uterus,  makes 
the  diagnosis  rather  easy.  Careful  examination  should  be 
made  in  all  cases  to  establish  a  correct  diagnosis  and  espe- 
cially to  differentiate  acute  metritis  from  puerperal  septicemia 
and  pyometra. 

Prognosis.— In  small  animals,  owing  to  the  difficulties 
encountered  in  the  treatment,  and  the  retention  of  the 
exudate  in  the  cornua,  the  prognosis  is  unfavorable.  The 
milder  cases  recover  but  there  is  always  danger,  even  in  the 
mild  cases,  of  chronic  metritis  or  pyometra  developing. 

Treatment.— Medical.— Owing  to  the  small  uterus  and  the 
long  cornua,  irrigation  is  a  more  difficult  problem  than  in 


296  DISEASES  OF  THE   UTERUS 

larger  animals.  However,  it  should  be  attempted  as  good 
results  often  follow  thorough  irrigation.  Boric  acid  (2  per 
cent.) ;  creolin  (1  per  cent.) ;  lysol  (1  per  cent.) ;  or  theropogen 
(2  per  cent.)  may  be  used  as  follows:  A  small  metallic 
catheter  or  flexible  human  male  catheter  is  inserted  into  the 
uterus  and  a  rubber  tube  and  funnel  attached  to  the  free 
end.  The  antiseptic  solution  is  allowed  to  flow  into  the 
uterus  by  gravity.  After  \  to  1  pint  of  the  solution  is  intro- 
duced the  tube  should  be  lowered  and  the  fluid  allowed  to 
flow  out.  The  catheter  is  introduced  into  each  cornua. 
This  treatment  should  be  applied  every  three  or  four  hours 
to  keep  up  the  antiseptic  action,  to  remove  the  exudate  and 
to  prevent  absorption  and  the  resulting  general  symptoms. 

Small  doses  of  ergot  or  other  ecbolics  should  be  adminis- 
tered once  daily  to  stimulate  the  uterus  and  to  hasten  its 
involution. 

Surgical. — In  severe  forms  of  acute  metritis,  and  in  cases 
where  medicinal  treatment  does  not  relieve,  it  is  advisable 
to  remove  the  uterus  and  ovaries  by  performing  laparo- 
hystero-oophorectomy. 

Chronic  Metritis.  —  Pyometra.— Definition.— A  chronic  in- 
flammation of  the  uterus,  characterized  by  the  formation 
and  collection  of  pus  in  the  uterine  cavity.  In  case  the 
cervical  canal  becomes  closed,  retaining  the  pus,  the  uterus 
may  be  converted  into  a  veritable  abscess.  Chronic  metritis 
occurs  quite  frequently  in  the  bitch;  less  commonly  in  cats. 
It  makes  its  appearance  in  most  cases  following  parturition, 
at  any  period  in  the  animal's  life,  but  may  be  found  in  females 
that  have  never  given  birth  to  young. 

Etiology.  — (a)  Commonly  a  sequel  to  acute  metritis,  the 
acute  symptoms  disappearing,  leaving  behind  bacteria  of  a 
low  virulence,  which  keep  up  a  constant  irritation  to  the 
inucosa  resulting  in  chronic  inflammation  with  pus  formation. 

(6)  Infection  gaining  entrance  to  some  portion  of  the 
reproductive  organs  which  may  find  its  way  to  the  uterus 
direct,  or  by  extension  of  the  process  from  other  parts  or 
adjacent  tissues,  leading  to  a  primary  inflammation  of 
chronic  type. 

(c)  Following  parturition  it  frequently  happens  that   a 


METRITIH  297 

small  portion  of  the  placenta  is  retained  leading  to  a  slowly 
developing  inflammation  with  pus  formation. 

(r/)  Injuries  of  a  mild  character  during  parturition,  or  at 
other  periods,  reduce  the  general  resistance  of  the  animal 
and  particularly  the  local  resistance  of  the  uterus  allowing 
infection  to  develop.  In  these  cases  we  will  often  find  that 
the  female  has  never  been  pregnant.  Such  cases  tend  to 
develop  into  uterine  abscess. 

(e)  Anything  which  reduces  the  resistance  of  the  repro- 
ductive organs  or  the  animal's  general  resistance  has  a 
tendency  to  favor  the  formation  of  this  condition.  Exposure 
is  a  predisposing  factor. 

Pathology.— The  presence  of  pus  in  varying  quantity  in 
the  uterus.  The  pus  is  thick,  viscid,  dark  or  reddish,  some- 
times reddish-gray  in  color  and  of  offensive  odor.  The  walls 
of  the  uterus  are  much  thickened,  dilated,  and  in  some  cases 
enormously  distended  with  pus  (uterine  abscess).  The 
mucosa  is  dark  in  color,  soft,  spongy,  and  shows  numerous 
elevations  of  various  sizes.  The  process  can  extend  into  both 
cornua.  In  general  the  animal  will  show  emaciation,  the 
muscles  are  pale,  soft  and  friable.  Secondary  abscesses  are 
often  observed  in  the  kidneys,  liver  and  lungs. 

Symptoms.— The  most  prominent  symptom  is  the  chronic 
discharge  from  the  vulva,  which  varies  in  quantity,  being 
more  copious  at  certain  times  than  at  others.  This  is  due 
to  the  fact  that  it  accumulates  in  the  uterus  until  a  certain 
distention  of  the  organ  is  reached,  when  it  will  be  ejected. 
The  discharge  is  grayish-red,  or  dark  red  in  color,  and  of  fetid 
odor.  It  soils  the  tail,  limbs,  and  hair  around  the  vulva. 
In  uterine  abscess,  with  occlusion  of  the  cervical  canal,  the 
discharge  will  be  absent. 

Enlargement  of  the  Abdomen.— In  all  cases,  and  particu- 
larly in  uterine  abscess,  there  is  a  marked  increase  in  the 
size  of  the  abdominal  cavity  which  may  simulate  pregnancy. 

Careful  palpation  should  be  made  especially  in  distention 
of  the  uterus  with  no  discharge  from  the  vulva  (uterine 
abscess). 

General  Symptoms.— In  all  cases  of  chronic  metritis 
systemic  disturbances  are  noted.  They  are  general  emacia- 


298  DISEASES  OF  THE   UTERUS 

tion,  weakness,  rough  hair  coat,  a  variable  appetite  and 
temperature. 

Diagnosis.— Diagnosis  does  not  present  much  difficulty 
as  the  symptoms  are  quite  characteristic.  Uterine  abscess 
should  be  differentiated  from  pregnancy,  distention  of  the 
bladder,  ascites,  tumors,  etc.  In  doubtful  cases,  laparotomy 
is  advisable. 

Prognosis.— Usually  favorable,  especially  so  when  the 
animal's  condition  is  still  good,  and  proper  treatment  pos- 
sible. Such  animals  cannot  be  used  for  breeding  as  the 
condition  in  the  uterus,  which  cannot  be  entirely  relieved, 
prevents  conception. 

Treatment.— Medical  treatment  is  of  little  value.  Irrigation 
of  the  uterus  with  an  antiseptic  solution  may  be  tried.  How- 
ever, surgical  treatment  is  necessary  in  order  to  properly  over- 
come the  general  symptoms.  An  early  removal  of  the  uterus 
and  ovaries  will  prevent  metastatic  abscesses  developing  in  the 
kidneys,  liver,  etc.  The  operation  is  as  follows :  The  animal 
should  be  given  a  general  anesthetic  and  placed  on  the  oper- 
ating table  in  the  dorsal  position  with  head  lowered.  The 
incision  is  made  in  the  median  line,  beginning  just  anterior  to 
the  pubis  and  extending  forward  a  sufficient  distance  to  allow 
the  uterus  to  be  drawn  out  of  the  abdominal  cavity.  Sterile 
silk  ligatures  (No.  10)  are  applied  around  the  broad  ligament 
at  the  distal  portion  of  the  ovary,  and  around  the  uterus 
just  anterior  to  the  cervix.  The  ligature  around  the  uterus 
should  be  placed  in  sections,  and  then  around  the  entire  part 
to  prevent  it  from  slipping  off  and  fatal  hemorrhage  resulting. 
The  entire  portion  between  the  ligatures  is  then  separated 
with  knife  or  scissors,  and  the  stumps  returned  to  the  abdom- 
inal cavity.  The  abdominal  incision  is  cared  for  in  the  regular 
way. 

In  case  of  collapse  or  weakness  following  the  operation 
small  doses  of  strychnin  (0.001)  should  be  given. 

PUERPERAL  SEPTICEMIA. 

Definition.— A  common  disease  in  small  animals  in  which 
either  bacteria  or  their  products  are  introduced  into  the 


PUERPERAL  SEPTICEMIA  299 

general  system.  Puerperal  septicemia  accompanies  to  a 
greater  or  less  extent  most  forms  of  septic  infection  of  the 
reproductive  organs  during  the  puerperal  state. 

Etiology.— Puerperal  septicemia  results  invariably  from 
retention  of  placenta,  a  fetus  or  fetuses,  or  from  wounds 
acquired  during  or  following  parturition.  Putrefaction 
changes  in  the  retained  placenta  occur  rapidly,  other  infection 
is  introduced,  and  the  products  of  bacteria  or  the  bacteria 
themselves  are  taken  into  the  circulation  producing  a  general 
septicemia  or  sapremia.  This  disease  may  follow  normal 
birth,  dystocia,  etc. 

Pathology. — The  changes  in  the  reproductive  organs  are 
often  slight  as  compared  to  the  severity  of  the  symptoms. 
The  blood  is  thin,  does  not  coagulate  readily.  The  muscles 
are  pale,  soft  and  friable.  Ecchymoses  are  observed  on  the 
serous  membranes,  particularly  in  the  abdominal  cavity. 
Parenchymatous  degeneration  is  noted  in  the  liver,  kidneys 
and  spleen. 

Symptoms.— The  symptoms  develop  rapidly,  usually  in 
from  one  to  three  clays  following  parturition.  There  is 
great  depression,  the  animal  lying  down  most  of  the  time; 
elevated  temperature  (106°-107°  F.),  increased  respirations 
and  pulse.  Later  appear  great  prostration,  subnormal  tem- 
perature, cold  extremities,  etc. 

Locally  the  generative  organs  show  marked  changes  in 
some  cases,  such  as  swelling  of  the  vulva,  the  mucosa  of  the 
vagina;  in  others  little  change  will  be  found.  There  is  nearly 
always  a  copious  discharge  from  the  vulva,  consisting  of  a 
greenish  colored  pus,  containing  shreds  of  placenta  and 
other  material.  This  discharge  has  a  very  offensive  odor. 

The  bowels  are  irregular,  in  some  cases  constipation  will 
be  present  and  in  others  a  severe  diarrhea.  The  symptoms 
usually  increase  in  intensity,  the  animal  reaching  a  stage 
of  coma  or  collapse.  In  the  milder  forms  of  infection,  and 
particularly  in  sapremic  conditions,  the  symptoms  gradually 
disappear  and  the  animals  make  a  complete  recovery. 

Diagnosis.— This  is  made  on  the  sudden  onset,  the  severe 
general  symptoms,  the  high  temperature  in  the  early  stages, 
and  the  characteristic  involvement  of  the  reproductive  organs. 


300  DISEASES  OF  THE   UTERUS 

Puerperal  septicemia  should  be  differentiated  from  acute  and 
chronic  metritis  which  can  be  made  by  a  careful  examination 
of  the  patient. 

Prognosis.— The  prognosis  is  unfavorable,  most  cases  ter- 
minating fatally.  Mild  cases  often  recover;  more  severe 
ones  may  recover  if  treatment  can  be  applied  early. 

Treatment.— Medical.— In  cases  of  marked  collapse,  sub- 
normal temperature,  etc.,  stimulants,  such  as  aromatic 
spirits  of  ammonia,  spirits  of  camphor,  oil  of  camphor,  or 
strychnin  should  be  administered  early. 

Surgical.— As  local  applications  in  the  form  of  irrigation 
with  antiseptics  have  proved  unsatisfactory,  an  early  opera- 
tion is  advised.  Before  operating  obviously  the  genital 
tract  should  be  flushed  with  antiseptics.  The  animal  should 
be  anesthetized  and  operated  as  in  chronic  metritis.  (See 
Chronic  Metritis.)  Care  must  be  exercised  in  preventing 
infection  of  the  serous  membrane  of  the  abdominal  cavity. 
The  stump  of  the  uterus  should  be  inverted  and  thoroughly 
disinfected  before  it  is  returned  to  the  abdominal  cavity. 

The  after-treatment  is  very  important,  and  prompt 
remedial  agents  (stimulants)  should  be  administered. 

Irrigation  of  the  vagina  should  be  done  at  regular  intervals 
to  control  local  infection.  Normal  salt  solution  should  be 
used  in  cases  of  collapse  following  the  operation.  It  is  best 
injected  intraperitoneally  (250  to  500  c.c.). 

EVERSION  OF  THE  UTERUS. 

Prolapse.  Inversion  of  the    Uterus. 

Eversion  of  the  uterus  is  not  common  in  the  small,  multip- 
arous  animals,  particularly  in  the  dog  and  cat.  The  small 
uterus  and  long  cornua  present  an  anatomical  arrangement 
which  tends  to  prevent  eversion  except  in  rare  instances. 

It  is  occasionally  observed  in  the  bitch  following  parturi- 
tion. The  eversion  in  most  cases  consists  of  an  invagination 
of  the  anterior  extremity  of  the  cornu  into  the  succeeding 
portion,  and  should  the  process  continue,  it  will  appear  at 
the  vulva  or  even  project  outside.  In  most  cases  the  pro- 
lapsed portion  will  consist  of  one  cornu  and  a  portion  of  the 


E VERSION  OF   THE   UTERUS  301 

uterus.  However,  in  a  few  instances  there  .will  be  found  a 
complete  eversion  of  both  cornua,  the  body  of  the  uterus  and 
a  portion  of  the  vagina.  The  prolapse  of  one  cornu  through 
the  uterus  usually  prevents  the  other  one  following. 

Symptoms. — The  early  indications  are  the  expulsive  efforts 
of  the  animal,  which  are  very  similar  to  those  noted  in  par- 
turition. The  animal  becomes  uneasy,  looking  at  its  sides, 
licking  the  vulva,  etc.  When  such  symptoms  occur  following 
parturition,  the  uterus  should  be  examined.  The  local  symp- 
toms after  the  uterus  appears  at  the  vulva,  are  quite  charac- 
teristic. There  is  a  rounded  enlargement  between  the  lips 
of  the  vulva,  at  first  only  slightly  congested  and  swollen, 
later  considerably  swollen  and  changed  in  colbr  to  a  dark  red 
or  almost  black.  When  the  organ  has  been  prolapsed  for 
some  time,  the  mucosa  becomes  darker,  covered  with  a  thick 
greenish  or  purulent  exudate,  and  in  some  cases  extensively 
gangrenous. 

General  symptoms  of  anxiety,  restlessness,  dyspnea, 
increased  labor  pains,  and  later  septicemia  are  observed. 

Diagnosis.  — In  small  animals  care  should  be  taken  to 
differentiate  eversion  of  the  uterus  from  prolapse  of  the 
vagina  or  its  mucosa,  tumors,  etc.  This  can  be  done  by 
inserting  the  finger  around  the  periphery  of  the  enlargement 
to  determine  its  point  of  origin.  Further,  the  characteristics 
of  the  prolapsed  portion  will  assist  in  the  diagnosis.  In  later 
stages,  when  necrosis  has  developed  with  much  swelling  of 
adjacent  tissues,  the  diagnosis  is  more  difficult. 

Prognosis.— Several  things  tend  to  alter  the  prognosis. 
More  favorable  are  those  cases  of  recent  development,  and 
especially  before  extensive  pathological  changes  have  taken 
place  in  the  uterus.  The  prognosis  is  unfavorable  if  amputa- 
tion of  the  uterus  is  necessary  on  account  of  the  danger  of 
septicemia.  The  prognosis  is  unfavorable  from  the  stand- 
point of  breeding. 

Treatment.  — In  case  the  prolapse  is  of  recent  development 
reposition  should  be  attempted  at  once.  The  parts  should 
be  thoroughly  cleansed  with  antiseptics  and  astringents. 
Reposition  should  be  attempted  by  gentle  pressure  on  the 
prolapsed  portion.  Patience  is  often  necessary  to  effect 


302  DISEASES  OF  THE   UTERUS 

reposition.  In  case  this  does  not  succeed,  it  is  advisable  to 
perform  laparotomy  under  anesthesia,  and  pull  the  uterus 
back  into  position.  Care  should  always  be  taken  to  avoid 
tearing  the  tissues,  and  it  is  best  to  have  an  assistant  manipu- 
late the  parts  in  the  vulva,  and  at  the  same  time  exert  some 
pressure  so  that  the  entire  prolapsed  portion  will  at  the 
same  time  go  back  into  position.  It  is  advisable  to  suspend 
the  uterus  to  the  abdominal  wall  after  it  has  been  withdrawn 
in  order  to  prevent  further  prolapsus.  This  can  be  done 
easily  by  simply  including  the  serous  and  muscular  coats  of 
the  uterus  in  the  sutures  when  closing  the  abdominal  walls. 

In  case  the  prolapsed  portion  is  necrotic  or  gangrenous 
it  should  be  amputated  at  once.  The  parts  are  cleansed 
thoroughly  with  antiseptics,  and  the  prolapsed  portion 
drawn  out  from  the  vulva  until  healthy  tissue  appears.  A 
ligature  is  applied  around  the  entire  mass  as  high  up  as  pos- 
sible. It  should  be  placed  in  position  by  drawing  it  tight 
to  avoid  postamputation  hemorrhage.  The  mass  is  then 
removed  with  a  scissors  or  knife.  Hemorrhage  should  be 
controlled,  if  present.  The  stump  is  thoroughly  washed  with 
antiseptics  and  returned  to  the  vagina.  The  vagina  should 
be  irrigated  with  antiseptics  for  a  few  days  following  the 
operation.  The  ligated  portion  will  slough  away  in  a  few 
days. 

TORSION  OF  THE  CORNUA  UTERI. 

This  is  a  condition  occurring  occasionally  in  bitches  pre- 
vious to  or  at  the  time  of  parturition.  A  twist  occurs  at  the 
junction  of  the  cornua  with  the  body  of  the  uterus,  prevent- 
ing the  birth  of  the  fetuses. 

Symptoms.— No  special  symptom  of  torsion  of  the  cornua 
will  be  observed.  It  may  be  necessary  to  make  a  careful 
examination  to  reveal  the  exact  condition;  in  some  cases 
an  explorative  laparotomy  must  be  made. 

Treatment.— The  torsion  can  be  reduced  by  performing 
laparotomy.  In  case  it  is  found  that  the  circulation  has  been 
so  disturbed  as  to  cause  necrosis,  it  will  be  best  to  amputate 
the  entire  organ. 


TUMORS  OF   THE   UTERUS  303 

RUPTURE  OF  THE  UTERUS. 

Rupture  of  the  uterus  has  been  observed  in  both  the  bitch 
and  cat.  It  may  be  due  to  unequal  uterine  contractions,  or 
to  the  rough  use  of  instruments  at  parturition. 

The  rupture  may  be  small,  simply  allowing  some  of  the 
fluids  from  the  uterus  to  escape  into  the  abdominal  cavity, 
or  may  be  of  sufficient  size  to  allow  the  fetus  to  pass  through. 
This  is  usually  a  serious  condition  on  account  of  the  infection 
getting  into  the  abdominal  cavity,  producing  septic  peri- 
tonitis. 

Symptoms.— The  stoppage  of  the  labor  pains,  and  the 
sudden  prostration  of  the  animal  are  the  most  characteristic 
symptoms.  Examination  should  be  made  by  inserting  the 
finger  through  the  vagina  into  the  uterus  and  at  the  same 
time  with  the  other  hand  pushing  upward  and  backward  on 
the  fetus.  If  there  is  membrane  between  the  fetus  and  finger, 
one  should  suspect  that  the  fetus  is  in  the  abdominal  cavity. 
Laparotomy  should  be  performed  at  once  to  make  a  positive 
diagnosis. 

Prognosis.— The  prognosis  is  unfavorable  owing  to  the 
danger  of  peritonitis. 

Treatment.— Prompt  surgical  treatment  should  be  given. 
The  fetus  and  membranes  should  at  once  be  removed,  and 
the  abdominal  cavity  flushed  thoroughly  with  normal  salt 
solution.  The  rent  in  the  uterus  is  closed  with  Lembert 
sutures.  Gauze  is  placed  between  two  of  the  sutures  in  the 
abdominal  wall  to  afford  drainage.  In  thirty-six  hours  this 
may  be  removed. 

TUMORS  OF  THE  UTERUS. 

Various  forms  of  tumors  have  been  observed  involving  the 
uterus  in  the  bitch  and  cat.  The  usual  varieties  are :  Fibro- 
mata, myomata,  cysts,  and  hydrometra.  Malignant  neo- 
plasms are  very  rare. 

Fibromata.— These  are  benign  tumors  found  involving  the 
muscular  wall  of  the  uterus.  In  the  majority  of  instances 
they  consist  in  part  of  fibrous  tissue,  and  myomatous  ele- 


304  DISEASES  OF  THE   UTERUS 

ments.  In  older  animals  there  is  a  preponderance  of  fibrous 
tissue.  They  develop  gradually  within  the  muscular  walls, 
and  project  into  the  lumen  of  the  organ  in  some  cases,  while 
in  others  the  growth  is  mainly  toward  the  peritoneal  cavity. 
When  extensive,  and  when  the  growth  is  toward  the  lumen 
of  the  organ,  they  may  be  found  projecting  through  the  os 
into  the  vagina.  They  are  characterized  by  their  slow  devel- 
opment. 

Symptoms.— The  first  indication  of  the  presence  of  fibro- 
mata will  be  an  increase  in  the  size  of  the  abdomen,  simulat- 
ing pregnancy.  However,  on  examination  by  palpation,  the 
difference  will  be  apparent  at  once.  Frequently  on  inserting 
the  finger  into  the  vagina  the  tumor  will  be  recognized,  and 
it  should  be  observed  whether  the  tumor  projects  from  the  os, 
or  is  attached  to  the  vaginal  wall.  No  general  disturbances 
are  noted,  except  when  the  tumor  becomes  of  sufficient  size 
to  interfere  with  the  function  of  the  abdominal  or  thoracic 
organs. 

Diagnosis.— The  enlargement  of  the  abdomen,  which  comes 
on  gradually,  the  lack  of  general  symptoms,  and  the  location 
of  the  enlargement  differentiate  it  from  pregnancy.  Further, 
through  laparotomy  the  uterus  may  be  examined  direct. 

Prognosis. —Favorable. 

Treatment.  —  Surgical. — Surgical  interference  by  complete 
removal  of  the  uterus  and  ovaries  is  indicated.  When  the 
tumors  are  found  projecting  through  the  os  into  the  vagina, 
they  should  be  withdrawn  into  the  abdominal  cavity  and 
extirpated. 

Myomata.  —In  myomatous  tumors  of  the  muscular  walls 
of  the  uterus,  the  symptoms,  diagnosis,  and  treatment  are 
the  same  as  for  fibromatous. 

Hydrometra.  Definition.—  A  collection  of  transudate  or 
other  sterile  fluid  in  the  uterus. 

Etiology.— Occlusion  of  the  cervix,  or  any  portion  of  the 
uterus  which  prevents  the  escape  of  fluid. 

Inflammation  of  the  cervix  (endocervicitis)  resulting  from 
wounds  and  injuries  during  parturition. 

Pressure  of  inguinal  hernia  producing  occlusion. 

It  may  be  produced  by  ligation  of  the  uterus,  as  is  done 


DYSTOCIA  305 

occasionally  to  prevent  pregnancy.  It  may  develop  as  a 
simple  hydrometra,  in  which  case  there  will  be  no  serious 
effects  upon  the  animal. 

Symptoms.— Distention  of  the  abdomen^  which  becomes 
pronounced  and  simulates  pregnancy.  Its  persistence  and 
the  absence  of  lactation  differentiate  it  from  pregnancy, 
however.  There  are  no  general  symptoms,  no  pain  on  manip- 
ulation of  the  abdomen,  and  no  change  in  the  other  parts 
of  the  reproductive  organs. 

Diagnosis.— Hydrometra  should  not  be  confused  with 
pregnancy,  tumors  of  the  uterus,  ascites,  and  pyometra.  A 
laparotomy  may  be  necessary  to  make  an  accurate  diagnosis. 

Prognosis. —Favorable. 

Treatment.— If  due  to  an  inguinal  hernia,  a  surgical  opera- 
tion is  necessary  for  relief.  In  other  cases  the  entire  uterus 
together  with  the  ovaries  should  be  removed. 


DYSTOCIA. 

Definition.— Difficult  parturition.  Dystocia  is  of  frequent 
occurrence  in  the  bitch  and  cat. 

Etiology.— Many  etiological  factors  produce  dystocia: 

1 .  In  a  mechanical  way  we  find  numerous  obstacles  which 
interfere  with  the  expulsion  of  the  fetus. 

(a)  Lack  of  expelling  power  of  the  uterine  muscles.  This 
is  frequently  due  to  general  weakness,  anemia,  etc. 

(6)  A  narrow  and  undilatable  pelvic  canal,  which  is  too 
small  for  the  fetus  to  pass. 

(c)  Constriction  of  the  os  uteri,  which  prevents  the  pas- 
sage of  the  fetus. 

(d)  Torsion   or  displacement  of   the  uterus,  closing  the 
uterine  exit. 

(e)  Abnormal  development  of  one  or  more  of  the  fetuses 
which  are  too  large  to  pass  through  the  pelvic  canal. 

(/)  Malpresentation  or  position  of  the  fetus  which  pre- 
vents it  entering  or  passing  through  the  pelvic  canal. 

(g)  Deformity  or  abnormality  in  the  development  of  the 
fetus.  In  some  instances,  as  in  hydrocephalus,  ascites,  or 
20 


306  DISEASES  OF   THE   UTERUS 

monstrosities,  they  are  too  large  to  pass  through  the  pelvic 
canal. 

(h)  There  is  frequently  a  narrowing  of  the  pelvic  canal 
from  tumors  in  the  vagina,  fractures  of  the  pelvic  bones  with 
enlargement,  etc. 

2.  It  has  been  observed  frequently  that  environment  has 
a  great  deal  to  do  with  producing  dystocia  in  the  bitch. 
Animals  that  are  kept  closely  confined,  fed  highly  nutritious 
food,  and  are  not  exercised,  are  more  predisposed  to  parturi- 
tion difficulties.    Some  breeds  are  more  often  affected  than 
others,  perhaps  due  in  most  cases  to  the  manner  in  which 
they  are  cared  for. 

3.  Mating  animals  of  extremes  in  size,  particularly  a  small 
female  bred  to  large  male.    The  young  will  be  too  large  in 
some  cases  to  be  expelled. 

4.  Young  females  at  the  first  birth  are  more  commonly 
affected  with  dystocia  than  at  later  periods. 

5.  Females  when  bred  before  reaching  complete  maturity 
often  will  have  difficulty  at  the  time  of  parturition. 

Symptoms.—  In  normal  parturition  it  requires  from  three 
to  thirty-six  hours  for  the  birth  of  the  young.  It  depends 
somewhat  on  the  number  of  fetuses,  and  the  condition  of  the 
animal.  Therefore  it  is  sometimes  difficult  to  determine 
accurately  the  time  at  which  dystocia  begins.  The  principal 
symptoms  of  dystocia  are:  Extreme  restlessness;  severe  labor 
pains  at  first,  later  their  cessation;  discharge  from  the 
vagina;  general  weakness. 

Examination  of  the  patient  will  determine  the  condition. 
The  following  examination  should  be  made  in  these  cases: 

Note  the  general  condition  in  regard  to  pulse,  respiration 
and  temperature.  Note  the  physical  condition. 

Palpate  the  abdominal  region  to  determine  whether  any 
young  are  present.  Differentiate  between  the  presence  of 
fetuses  and  other  enlargements  commonly  found  in  this 
location. 

Note  the  condition  of  the  external  genitals;  the  discharge 
from  the  vulva.  I  )isinfect  the  fingers  and  palpate  through  the 
vagina.  If  the  fetus  has  been  presented  at  the  pelvic  inlet, 
it  can  be  felt.  If  still  in  the  uterus  it  mav  not  be  determined 


DYSTOCIA  307 

by  vaginal  palpation.  In  palpating  note  the  condition  of  the 
pelvic  canal,  whether  constricted,  tumors  present,  etc. 

Diagnosis. — If  the  labor  pains  are  normal  and  no  impedi- 
ment to  the  passage  of  the  young  through  the  pelvic  canal  is 
apparent,  and  the  animal  is  in  good  physical  condition,  we 
should  allow  more  time  to  elapse  before  assuming  it  to  be  a 
case  of  dystocia.  However,  if  the  animal  is  weak,  the  general 
condition  disturbed,  labor  pains  absent,  etc.,  we  are  justified 
in  diagnosing  dystocia. 

Prognosis.— Favorable  in  most  cases.  Will  depend  upon 
(a)  the  condition  of  the  animal,  (6)  the  length  of  time  in 
labor,  and  (c)  the  condition  of  the  fetus  and  membranes. 

Treatment.— A  thorough  examination  of  the  patient  should 
be  made  at  once  to  determine  the  proper  treatment  to  use. 
There  are  three  lines  of  treatment  recommended  in  dystocia. 

Medical.— This  is  indicated  in  cases  when  there  is  no 
apparent  impediment  to  the  passage  of  the  fetus,  and  when 
the  labor  pains  are  weak  and  insufficient.  Extract  of  ergot 
(0.5-2.0)  or  pituitrin  (3.0-10.0)  depending  on  the  size  of  the 
animal  may  be  given.  These  doses  may  be  repeated  in  a  few 
hours  if  necessary.  Pituitrin  is  being  used  quite  successfully 
in  such  cases. 

Forced  Extraction  of  the  Fetus.  —  Examination  is  made  of 
the  condition  of  the  birth  canal  and  the  position  of  the  fetus 
noted.  Various  forms  of  instruments  have  been  recom- 
mended for  this  work.  Perhaps  the  most  satisfactory  ones 
are  the  smallest  forceps,  a  rather  blunt  vulsellum  forceps, 
and  a  wire  snare.  These  instruments  should  be  thoroughly 
disinfected,  and  the  vagina  washed  with  an  antiseptic  and 
lubricant  solution  (creolin,  2  per  cent.;  lysol,  1  per  cent.). 
The  method  of  manipulation  will  depend  upon  the  position, 
presentation,  and  condition  of  the  fetus.  All  manipulating 
with  the  instruments  should  be  done  carefully  to  avoid  injur- 
ing the  vaginal  mucosa.  An  assistant  who  exerts  pressure 
on  the  abdominal  walls  in  a  backward  direction  will  often 
help  in  keeping  the  fetus  in  position  until  the  instrument  is 
firmly  attached.  Gentle  traction  should  be  used.  This 
method  when  done  carefully  will  often  overcome  the  diffi- 
cult v. 


308  DISEASES  OF  THE   UTERUS 

Hysterotomy.—Aher  examination  of  the  patient  it  is  found 
that  it  is  impossible  for  the  fetus  to  be  born,  or  after  the  other 
methods  of  treatment  have  failed,  it  is  advisable  to  perform 
hysterotomy  as  early  as  possible.  Delay  in  performing  the 
operation  is  often  fatal  on  account  of  the  infection  in  the 
uterus  from  resulting  sapremia  or  septicemia. 

The  animal  is  anesthetized,  placed  on  the  table  in  a  dorsal 
position,  well  hoppled.  An  incision  is  made  through  the 
abdominal  walls  in  the  median  line  just  anterior  to  the  pubis 
and  extended  forward  about  three  to  four  inches.  The  uterus 
will  at  once  be  seen  as  a  voluminous  body.  It  is  withdrawn 
carefully  from  the  cavity  well  surrounded  by  sterile  gauze 
to  prevent  fluids  from  flowing  back  into  the  abdominal 
cavity.  An  incision  is  made  through  the  walls  of  the  uterus 
of  sufficient  size  to  allow  the  fetus  or  fetuses  to  be  withdrawn. 
If  there  should  be  any  fetus  in  either  of  the  cornua  they  can 
be  removed  through  the  same  opening.  The  membranes 
and  any  other  material  should  be  removed  from  the  uterus. 
The  incision  in  the  uterus  is  closed  with  Lembert  sutures  and 
returned  to  the  abdominal  cavity.  The  abdominal  incision 
closed  as  usual. 

General  stimulants  should  be  administered  following  the 
operation. 

Hysterectomy  is  advisable  in  cases  where  there  is  evidence 
of  puerperal  infection.  (See  Chronic  Metritis.) 


CHAPTER  VII. 
DISEASES  OF  THE  VAGINA  AND  VULVA. 

Examination.— It  is  possible  to  make  a  thorough  examina- 
tion of  the  vagina  and  vulva  by  direct  inspection.  The  animal 
should  be  placed  in  a  dorsal  position  with  the  hind  limbs 
hoppled  forward.  The  vulva  can  be  inspected  directly  by 
separating  the  labia  with  the  fingers.  The  condition  of  the 
mucosa  should  be  observed,  any  wounds  or  injuries  carefully 
examined  to  determine  their  depth  and  extent.  Note  the 
color  of  the  mucosa.  It  should  be  remembered  that  in  the 
bitch  there  is  often  a  normal  pigmentation  of  the  mucosa 
which  should  not  be  mistaken  for  some  diseased  condition. 
Papillomata  and  fibromata  are  commonly  found  at  the  junc- 
ture of  the  skin  and  mucous  membrane.  The  vagina  may  be 
inspected  by  using  a  speculum  to  dilate  the  vulva  and  a 
portion  of  the  vagina  so  that  the  mucosa  can  be  seen.  It  is 
best  to  use  an  artificial  light  with  a  reflector  to  observe  the 
mucosa  farther  into  the  pelvic  canal.  The  mucosa  should 
be  examined  for  wounds  and  injuries  which  are  common 
sequels  to  dystocia,  inflammation,  tumors,  prolapsus,  con- 
strictions, etc. 

CONGENITAL  MALFORMATIONS. 

Various  forms  of  malformations  have  been  observed  in  the 
bitch  and  cat.  Stenosis  of  the  vagina  is  seen  occasionally. 
Imperfect  development  of  the  vulva,  vagina  and  anus  during 
fetal  life  has  been  noted.  These  conditions  may  interfere 
with  copulation  and  impregnation.  When  found  an  attempt 
should  be  made  to  correct  them  surgically. 

VAGINITIS  AND  VULVITIS. 

Definition.— An  acute  or  chronic  inflammation  of  the  vagina 
and  vulva.  These  are  very  common  conditions  found  in  both 
the  bitch  and  cat. 


310         DISEASES  OF  THE   VAGINA   AND   VULVA 

Etiology.— Mechanically  there  are  a  number  of  conditions 
which  bring  about  inflammation  of  these  parts.  Anything 
causing  bruising  of  the  mucosa  will  result  in  an  inflammatory 
condition  varying  in  degree  and  depending  upon  the  extent 
of  the  injury.  Lacerations  and  abrasions  of  the  mucosa  make 
possible  the  entrance  of  bacteria  with  resultant  inflamma- 
tion. During  dystocia,  wounds,  and  lacerations  of  the  vulva 
and  vagina  are  very  common  from  rough  manipulations  and 
sharp  instruments.  At  this  time  the  animal's  general  resist- 
ance is  materially  reduced  and  serious  infection  and  infiltra- 
tion of  the  tissues  can  take  place.  Infection  is  frequently 
introduced  by  infected  fingers  or  instruments.  Another 
factor  of  importance  in  these  cases  following  dystocia  is  the 
fact  that  in  the  extraction  of  the  fetus,  or  the  discharge  of 
the  secretions  from  the  uterus,  the  vagina  is  further  exposed 
to  infectious  material. 

Foreign  bodies  finding  their  way  into  the  vagina  will  pro- 
duce inflammatory  conditions  depending  upon  the  kind  of 
foreign  body  and  the  extent  of  the  injury  done  by  the  same. 
Tumors  in  the  vaginal  wall  usually  produce  a  chronic  inflam- 
mation. 

Symptoms.— Acute  inflammation  of  the  vulva  is  apparent 
from  the  swelling  of  the  labia  and  the  congestion  of  the 
mucous  membrane.  The  color  of  the  mucosa  is  at  first  red, 
later  of  a  bluish,  or  greenish-black,  depending  upon  the  stage 
of  the  inflammatory  process.  At  first  there  is  no  discharge, 
but  later  a  mucous  or  mucopurulent  discharge  is  observed. 
In  acute  vaginitis  the  mucosa  will  be  red  in  color,  swollen, 
and  in  most  cases  the  seat  of  the  injury  or  infection  will  be 
observed.  The  animal  will  be  restless,  often  shows  symptoms 
of  straining  as  if  to  urinate.  General  symptoms  of  elevation 
of  temperature,  disturbances  in  the  circulation  and  respira- 
tion are  often  observed  from  the  absorption  of  the  toxins, 
or  the  presence  of  microorganisms  in  the  blood.  In  chronic 
vaginitis  the  principal  symptom  is  the  chronic,  whitish, 
purulent  discharge  from  the  vulva.  Examination  reveals 
the  chronic  inflammatory  changes  of  the  mucosa  of  the 
vagina  and  vulva.  In  most  of  these  cases  it  is  difficult  to 
make  a  distinction  between  the  two  conditions  as  they  are 
nearly  always  associated  except  in  injuries. 


PROLAPSE  OF  THE  VAGINA         311 

Diagnosis.— This  is  made  by  a  direct  inspection  of  the 
mucosa. 

Prognosis. — Favorable  in  most  cases,  unless  general  symp- 
toms of  septicemia  are  present,  or  in  some  cases  of  extensive 
laceration  of  the  mucous  membrane. 

Treatment.  —The  parts  should  be  thoroughly  cleansed  with 
mild  antiseptics  (lysol,  2  per  cent.),  followed  by  weak  solu- 
tions of  astringents  (silver  nitrate,  0.25  per  cent.,  or  silver 
citrate  0.5  per  cent.).  These  applications  should  be  made 
daily. 

In  case  any  foreign  bodies  are  present,  they  should  be 
removed  and  antiseptic  treatment  applied.  When  the  vulva 
or  vagina  is  found  lacerated  the  extent  of  the  wound  should 
be  determined  by  probing,  all  loose  fragments  removed  with 
the  scissors,  and  antiseptics  used  as  above. 

In  gangrenous  conditions  of  the  vulva  or  mucosa,  all  such 
portions  must  be  removed  promptly,  and  the  surface  treated 
thoroughly  with  antiseptic  solutions.  It  is  sometimes  neces- 
sary in  recent  wounds  of  the  vulva  to  apply  one  or  more 
sutures  to  properly  approximate  the  torn  edges  to  prevent 
improper  union. 

PROLAPSE  OF  THE  VAGINA. 

A  true  prolapsus  of  the  vagina  is  uncommon  in  small 
animals.  A  hypertrophic  condition  of  a  portion  of  the 
mucosa  which  protrudes  through  the  vulvar  opening  is 
frequently  mistaken  for  prolapsus.  This,  however,  is  not  a 
true  prolapsus,  but  inasmuch  as  it  simulates  the  condition, 
it  will  be  described  with  prolapsus. 

Etiology.— Prolapse  of  the  vagina  often  results  from  injuries 
during  copulation,  the  penis,  which  is  forcibly  withdrawn 
before  ejaculation  has  taken  place,  pulling  the  vaginal 
mucosa  out  with  it. 

Results  also  from  severe  straining,  and  from  inflammation 
of  the  mucosa.  Hypertrophy  of  the  mucosa  is  observed 
frequently  in  some  of  the  larger  breeds,  Great  Danes,  St. 
Bernards,  and  becomes  a  chronic  and  especially  prominent 
following  the  estrual  period.  It  consists  of  simply  a  chronic 
•  inflammation  which  is  most  marked  during  estruation. 


312         DISEASES  OF  THE  VAGINA  AND  VULVA 

Symptoms.— The  condition  is  characterized  by  an  enlarge- 
ment appearing  at  the  vulvar  opening.  At  first  the  prolapsus 
is  a  red,  congested  mass,  which  later,  on  exposure,  becomes 
dark  in  color  and  gangrenous.  In  hypertrophy  of  the  mucosa 
it  appears  as  a  rounded  enlargement  of  rather  firm  consist- 
ency projecting  through  the  vulvar  opening  and  coming  from 
one  side  of  the  vaginal  wall.  In  some  cases  it  will  remain 
outside  of  the  vulva,  becoming  dark  in  color  and  gangrenous 
on  the  surface;  or  it  may  not  protrude  beyond  the  vulvar 
opening  and  appear  only  at  intervals.  Usually  there  are  no 
general  symptoms.  There  may  be  some  interference  with 
micturition. 

Diagnosis.— This  is  not  difficult  in  most  cases.  A  thorough 
manual  examination  should  be  made  to  determine  the  exact 
conditions  present. 

Prognosis. —Favorable. 

Treatment.— In  prolapsus  of  the  vagina  an  attempt  should 
be  made  to  replace  it.  The  parts  should  be  cleansed,  disin- 
fected and  if  there  is  much  congestion,  astringents  (alum,  2 
per  cent.)  may  be  used.  In  some  cases  this  will  be  sufficient, 
in  others  when  there  is  a  recurrence  of  the  condition  without 
necrosis  or  gangrene,  it  should  be  returned  and  if  necessary 
held  in  place  by  temporary  sutures  through  the  labia  of  the 
vulva.  They  should  be  placed  so  that  the  urine  can  be 
voided.  Remove  them  in  twenty-four  to  forty-eight  hours. 
When  gangrene  sets  in,  amputation  of  the  prolapsed  portion 
becomes  necessary.  This  is  done  by  grasping  the  mass  and 
withdrawing  it  until  the  normal  mucosa  appears.  If  the 
prolapsus  involves  only  a  portion  of  the  circumference  of  the 
vagina  it  may  be  ligated.  The  ligature  should  be  inserted 
through  the  base  of  the  mass  and  drawn  securely  to  control 
hemorrhage  and  stop  absorption.  In  case  the  vagina  is 
prolapsed,  throughout  its  whole  circumference  sectional 
suturing  will  be  necessary.  Care  must  be  taken  in  all  cases 
to  avoid  injuring  the  urethra.  In  hypertrophy  of  the  mucosa 
amputation  of  the  mass  is  necessary.  This  is  done  by  thor- 
ough cleansing  and  disinfecting  the  parts,  withdrawing  the 
mass  from  the  vulva,  and  ligating  through  its  base.  The 
mass  should  be  removed  with  the  knife  or  scissors  and  the 


TUMORS  OF  THE  VULVA  AND   VAGINA  313 

stump  returned  to  the  vagina.   The  vagina  should  be  cleansed 
daily  with  antiseptics  until  the  discharge  has  ceased. 

RUPTURE  OF  THE  VAGINA. 

During  dystocia  from  rough  manipulation,  or  from  sharp 
instruments  the  vagina  may  be  torn  or  ruptured  making  at 
once  an  opening  into  the  abdominal  cavity.  This  will  allow 
septic  material  to  gain  entrance  which  usually  produces  peri- 
tonitis. In  some  cases  after  rupture  of  the  vagina,  and  when 
straining  is  induced,  or  still  present  from  the  dystocia,  there 
may  be  a  prolapsus  of  the  bladder  through  the  rent.  When 
this  occurs  the  bladder  becomes  displaced  and  projects  from 
the  vulva.  It  will  be  recognized  as  a  fluctuating  enlargement 
appearing  suddenly  between  the  labia  of  the  vulva.  An 
exploring  trocar  may  be  used  to  determine  its  contents  if  the 
diagnosis  is  in  doubt.  Laparotomy  should  be  performed  at 
once  (see  Laparotomy)  and  the  displaced  organs  returned  to 
their  normal  position.  If  possible  close  the  opening  in  the 
vagina.  If  septic  infection  has  developed  little  can  be  done. 

TUMORS  OF  THE  VULVA  AND  VAGINA. 

The  majority  of  the  neoplasms  found  in  the  vulva  and 
vagina  are  benign  growths  consisting  in  most  instances  of 
fibromata,  papillomata,  or  a  mixture  of  fibromata  with 
myxomatous,  myomatous,  or  lipomatous  elements.  Malig- 
nant tumors  are  uncommon  in  the  vagina,  but  do  occur 
occasionally  as  secondary  growths,  or  in  the  form  of  venereal 
granulomata. 

Fibromata.— These  are  found  in  most  instances  projecting 
from  the  walls  of  the  vagina,  or  from  the  cervix.  They 
appear  as  hard,  firm  enlargements,  usually  smooth  on  the 
surface,  show  no  tendency  to  degeneration  or  necrosis,  except 
when  they  project  through  the  vulva  and  become  irritated 
from  exposure. 

Diagnosis.— Made  by  the  character  of  the  enlargement,  its 
slow  growth  and  finally  by  a  microscopic  examination. 

Prognosis. — Favorable  in  most  cases. 


314         DISEASES  OF  THE   VAGINA  AND   VULVA 

Treatment. —Complete  amputation  should  be  done  as  early 
as  possible.  Ligation,  the  same  as  for  hypertrophy  of  the 
mucosa,  is  perhaps  the  most  satisfactory  method. 

Papillomata. — These  occur  at  the  juncture  of  the  skin 
and  mucous  membrane  of  the  vulva.  They  appear  as  small, 
rounded,  pedunculated  (usually)  tumors.  They  often  have 
a  roughened  surface. 

Treatment.— Papillomata  should  be  removed  with  the 
scissors,  and  the  bases  cauterized  with  silver  nitrate.  They 
rarely  reappear. 

Sarcomata.— These  are  found  occasionally  on  the  vaginal- 
mucosa.  They  are  characterized  by  their  rather  rapid 
growth,  uneven  surface,  and  tendency  to  spread  to  adjacent 
structures.  If  possible  a  small  section  should  be  obtained 
for  microscopic  examination. 

Treatment.— Treatment  is  unsatisfactory  and  should  not 
be  attempted. 

Venereal  Granulomata.— Venereal  granulomata  have  been 
described  under  venereal  granulomata  in  the  male  animal. 
In  the  female  they  appear  on  the  mucosa  of  the  vulva  and 
at  the  posterior  portion  of  the  vagina.  They  consist  of  pro- 
gressive neoplasms  varying  in  rapidity  of  growth. 

Treatment. — Complete  removal  should  be  attempted, 
except  in  very  advanced  cases. 


CHAPTER  VIII. 
DISEASES  OF  THE  MAMMARY  GLANDS. 

Examination.— These  glands  may  be  examined  by  observing 
their  size,  condition,  and  by  palpation  to  note  their  consist- 
ency or  the  presence  of  wounds,  inflammation,  abscesses,  etc. 

WOUNDS  AND  INJURIES  OF  THE  MAMMARY 
GLANDS. 

In  the  bitch  and  cat,  wounds  and  bruises  of  the  mammary 
glands  are  quite  common.  They  result  in  most  instances 
from  being  run  over  by  vehicles,  by  falling,  from  bites  of 
other  animals,  or  the  glands  may  be  punctured  by  sharp 
objects.  The  degree  of  injury  will  vary  greatly.  In  some 
cases  it  will  consist  in  a  simple,  slight  contusion  of  the  gland- 
ular substance;  in  others  bruising  with  hemorrhage  into  the 
gland  producing  a  hematoma,  and  in  some  cases  abscesses 
result.  A  careful  examination  should  be  made  to  determine 
the  degree  and  extent  of  the  injury. 

Treatment.— The  treatment  will  depend  to  a  great  extent 
on  the  condition  of  the  glands.  In  slight  contusions  but  little 
treatment  is  necessary,  while  in  more  extensive  bruising, 
warm  applications  should  be  applied  in  the  form  of  a  warm 
antiseptic  pack  containing  lysol  (2  per  cent.).  In  open 
wounds  their  extent  should  be  determined  and  treated  with 
antiseptics.  An  antiseptic  pack  may  be  applied  when  the 
animal  interferes  with  the  wound  by  biting  or  licking  it 
excessively. 

When  abscesses  develop  in  the  gland,  they  should  be 
opened  freely  to  allow  good  drainage  and  the  wound  treated 
as  above.  In  most  cases  recovery  takes  place  promptly.  If 
fistula  or  necrosis  of  the  gland  should  develop,  it  may  be 
amputated. 


316  DISEASES  OF  THE  MAMMARY  GLANDS 

CONGESTION  OF  THE  MAMMARY  GLANDS. 

A  normal  condition  occurring  at  the  end  of  the  gestation 
period,  and  during  lactation.  It  has  been  observed  in  non- 
pregnant  and  virgin  animals.  The  glands  become  enlarged, 
hot,  and  sensitive.  No  treatment  is  necessary. 

MAMMITIS.     MASTITIS. 

Definition.— An  inflammation  of  the  mammary  glands. 
The  inflammation  may  involve  one  or  more  of  the  glands. 
Mastitis  is  a  common  condition  in  bitches  and  cats  shortly 
after  parturition. 

Etiology.— In  the  majority  of  cases  mastitis  is  due  to  infec- 
tion. Pyogenic  organisms  enter  usually  through  the  teat 
canal  to  the  acini  of  the  gland,  and  from  this  point  spread  to 
the  perilobular  lymphatics. 

Premature  removal  of  the  young  seems  to  be  a  predisposing 
factor  as  it  permits  the  milk  to  collect,  congesting  the  gland 
as  is  often  noted  in  cats.  Streptococcus  infection  of  the 
mammary  glands  of  the  cat  has  been  quite  often  observed. 
It  frequently  has  the  appearance  of  a  specific  disease  appear- 
ing as  an  enzootic  in  catteries.  Wounds  and  contusions  of 
the  gland  will  produce  mammitis  and  the  degree  will  depend 
upon  whether  or  not  there  is  infection.  Chronic  mammitis  is 
observed  occasionally  in  the  bitch  and  cat,  resulting  either 
from  acute  mammitis,  or  occurring  independently. 

Symptoms.  —  One  or  more  of  the  mammary  glands  are 
swollen,  hot,  and  very  sensitive  on  palpation.  As  there  are 
no  milk  cisterns  in  the  gland,  the  condition  extends  immedi- 
ately to  the  glandular  tissue  producing  marked  inflammation 
and  edema  of  portions  of  the  gland.  On  palpation  the 
portion  aft'ected  can  be  detected.  Later  as  the  infection 
develops  the  milk  will  be  found  changed  into  a  grayish, 
purulent  mass  sometimes  mixed  with  blood.  Abscesses, 
often  multiple,  frequently  develop.  They  open  and  dis- 
charge a  reddish,  purulent  mass.  General  symptoms  are 
quite  marked  in  some  cases,  especially  in  cats.  The  toxins 
absorbed  produce  general  intoxication  which  is  often  fatal. 


TUMORS  OF  THE  MAMMARY  GLANDS  317 

In  the  chronic  form  the  glands  become  indurated  and  the 
milk  canals  obliterated.  The  gland  tissue  becomes  fibroid 
in  character. 

Prognosis.— The  prognosis  is  favorable  in  animals  other 
than  the  cat.  When  general  symptoms  are  present  the 
prognosis  should  be  guarded. 

Treatment.— The  milk  is  removed,  and  the  glands 
thoroughly  massaged  to  remove  as  much  of  the  infective 
material  as  possible.  Hot  antiseptic  packs  or  fomentations 
of  hot  antiseptic  solutions  should  be  applied.  These  should 
be  changed  every  few  hours  if  feasible.  Avoid  coal-tar 
products  in  cats. 

Should  abscesses  develop  in  the  glands  they  are  incised  to 
give  free  drainage.  Follow  with  antiseptics.  Small  doses  of 
castor  oil,  or  magnesium  sulphate  are  indicated  to  assist  in 
the  elimination  of  toxins.  In  chronic  mammitis  with 
fibrosis  which  may  also  involve  the  teat,  it  is  best  to  remove 
the  gland.  An  anesthetic  should  be  given,  and  the  animal 
placed  on  the  table  in  the  dorsal  position.  The  hair  is 
shaved  from  around  the  gland  and  the  skin  thoroughly 
disinfected.  The  gland  is  then  dissected  out,  which  is  not 
difficult,  and  the  vessels  ligated.  The  skin  should  be  trimmed 
so  that  the  edges  approximate  accurately.  A  regular  bitch 
bandage  is  applied  to  protect  the  wound.  Recovery  is 
prompt. 


TUMORS  OF  THE  MAMMARY  GLANDS. 

Neoplasia  of  the  mammary  glands  is  of  frequent  occur- 
rence in  bitches.  Both  benign  and  malignant  types  are  met 
with  in  practice. 

Benign  Tumors.— Fibromata.— A  very  common  form  of 
benign  tumor  found  in  the  mammary  gland  of  bitches.  It 
consists  of  fibrous  tissue  elements  proliferating  around  and 
into  the  glandular  acini,  isolating  portions  of  the  gland  cells. 
Their  development  is  slow  but  progressive,  ultimately 
involving  the  entire  gland.  The  tumor  may  appear  as  a 
pure  fibroma  or  be  mixed  with  other  varieties. 


318  DISEASES  OF  THE  MAMMARY  GLANDS 

Symptoms.— Fibromas  occur  as  hard,  sharply  defined 
enlargements  which  show  no  inflammatory  symptoms  nor 
tendency  to  degenerate.  The  size  of  the  tumors  varies  from 
a  pea  to  several  inches  in  diameter.  When  mixed  with  other 
tumors,  they  are  softer  and  take  on  some  of  their  charac- 
teristics. 

Progn  osis.— Favorable. 

Treatment.— Extirpation  of  the  gland. 

Lipoma.— Fatty  tumor  found  in  old  bitches,  especially  in 
those  afflicted  with  obesity. 

Symptoms.— They  are  soft,  well-defined  tumors  of  the 
gland. 

Prognosis.  —  Favorable. 

Treatment.  —  Removal  of  the  gland  is  advisable. 

Malignant  Tumors.—  Carcinomata.  —  A  very  common  form 
of  malignant  growth  found  in  the  mammary  gland.  They 
are  frequently  mixed  tumors,  appearing  as  adenocarcinoma, 
fibrocarcinoma,  etc. 

Symptoms.— Carcinomas  are  characterized  by  their  growth, 
slow  at  first  but  with  sudden,  rapid  development,  lobulated 
appearance,  and  tendency  to  degeneration  and  abscess 
formation.  A  small  portion  of  the  tumor  should  be  examined 
microscopically. 

Progn  osis.  —  Unfavorable  as  they  are  apt  to  recur. 

Treatment.  —  Removal  of  the  gland  should  be  done  as  early 
as  possible.  When  metastasis  has  taken  place,  no  treatment 
is  successful. 

Sarcomata.— Sarcomata  occur  usually  in  conjunction  with 
other  varieties  of  tumor,  as  fibrosarcoma,  adenosarcoma,  etc. 

Symptoms.— Sarcomas  develop  rapidly  with  acute,  inflam- 
matory symptoms. 

Diagnosis. — A  diagnosis  can  be  made  only  by  microscopical 
examination. 

Treatment.— Same  as  for  carcinoma. 

Other  varieties  of  tumors  which  involve  the  mammary 
glands  are  rare  and  of  minor  importance. 


PART  V. 

DISEASES  OF  THE  BLOOD  AND  BLOOD 
PRODUCING  ORGANS. 


CHAPTER   I. 
ANEMIA. 

Definition.— A  reduction  in  the  total  volume  of  blood  or 
of  its  corpuscles,  oligocythemia,  or  of  certain  of  its  more 
important  constituents,  such  as  albumin  and  hemoglobin. 
Two  forms  of  anemia  are  recognized,  viz.:  (a)  Acute,  and 
(6)  chronic. 

Occurrence.— Very  frequently  observed  in  dogs  and  cats. 
The  most  common  form  is  the  acute.  The  chronic  form 
following  various  diseases  is  also  of  common  occurrence. 

Etiology.  — (a)  Many  cases  of  acute  anemia  are  the  direct 
result  of  loss  of  blood.  The  condition  develops  rapidly 
following  epistaxis,  intestinal  hemorrhage,  rupture  of  blood- 
vessels in  the  lungs,  hemorrhage  of  the  uterus,  parenchy- 
matous  hemorrhage,  or  any  external,  severe  hemorrhage. 

(6)  Chronic  anemia  develops  slowly  and  gradually. 
Several  different  causes  are  found  producing  this  type: 
Insufficient  food,  or  food  of  poor  quality  in  which  the  essential 
nutritive  elements  are  deficient;  diseases  of  metabolism  in 
which  the  nutritive  processes  are  modified  and  the  food 
elements  not  utilized  in  the  body.  In  small  animals  anemia 
often  follows  diseases  of  the  digestive  tract  (catarrhal  inflam- 
mation) producing  either  a  loss  of  appetite  or  an  interference 
in  the  digestion  and  assimilation  of  the  food.  This  may 


320  ANEMIA 

occur  following  distemper  in  dogs,  presence  of  parasites  in 
large  numbers,  or  other  diseases  affecting  the  mucous  mem- 
branes in  a  similar  manner.  Large  numbers  of  chickens  are 
sometimes  found  with  anemia  from  infectious  asthenia,  and 
other  diseases  of  the  digestive  tract.  Parasites  of  the  blood 
are  occasionally  the  cause.  Young  chicks  are  frequently 
affected  with  white  diarrhea  resulting  in  a  severe  form  of 
anemia.  Many  of  the  general  diseases  are  accompanied  by 
anemia. 

Pathology. — The  most  characteristic  feature  of  acute 
anemia  is  the  paleness  of  all  the  tissues  and  the  absence  of 
blood.  The  respiratory  passages  show  evidence  of  lack  of 
blood  by  their  pale,  pink  color.  The  heart  and  bloodvessels 
are  only  partially  filled  with  a  loose  coagulated  blood.  In 
chronic  anemia  the  membranes  are  found  pale  and  colorless, 
the  blood  present  in  the  vessels  and  tissues  low  in  coloring 
matter,  and  usually  reduced  in  total  volume.  Fatty  degen- 
eration of  the  heart,  liver,  kidneys  and  other  organs  is  often 
observed.  Owing  to  the  general  weakness  and  emaciation, 
transudation  of  serum  takes  place  and  is  found  present  in 
the  thoracic  and  abdominal  cavities  in  varying  quantities. 
Lesions  of  the  primary  condition  producing  anemia  are  often 
apparent. 

Symptoms,  —  (a)  Acute  Anemia.— The  symptoms  of  acute 
anemia,  when  due  to  hemorrhage,  come  on  suddenly,  and 
depend  upon  the  amount  of  blood  lost.  The  patient  becomes 
very  weak,  may  be  unable  to  stand,  or  if  standing  does  so 
with  difficulty.  In  attempts  at  walking  the  animal  will  show 
muscular  incoordination  and  frequently  falls  down.  Depres- 
sion, subnormal  temperature  and  increased  respirations  are 
prominent  symptoms.  The  mucous  membranes  are  pale  or 
colorless  and  the  heart  action  may  be  very  weak  or  imper- 
ceptible. In  some  instances  evidence  of  the  hemorrhage  will 
be  present  by  the  discharge  of  blood  either  from  the  nasal 
passages,  mouth  or  wound.  Many  cases  terminate  fatally 
in  a  few  minutes,  or  hours,  when  the  hemorrhage  is  severe. 

(b)  Chronic  Anemia.  —  In  chronic  anemia  the  symptoms 
come  on  more  slowly  and  gradually  with  more  or  less  emacia- 
tion and  general  debility.  The  hair  coat  or  plumage  becomes 


ANEMIA  321 

rough,  and  the  eyes  sunken.  The  animal  is  easily  fatigued, 
and  unsteady  in  its  movements.  It  will  lie  down  much  of 
the  time  and  refuses  to  move  or  get  up  when  called.  The 
mucous  membranes  are  pale  or  colorless.  The  heart  action 
is  irregular,  the  pulse  weak,  and  the  respirations  shallow  and 
accelerated.  The  appetite  becomes  variable  and  entirely 
suppressed  in  some  cases ;  in  others  it  is  retained  but  weakness 
and  emaciation  continue.  The  blood  when  examined  will 
show  a  reduction  in  hemoglobin  content  and  the  number  of 
red  corpuscles  diminished  in  proportion  to  the  number  of 
white.  Later  as  the  disease  progresses  edematous  swellings 
are  found  along  the  abdomen,  under  the  neck,  and  on  the 
limbs.  Other  symptoms  may  be  present  depending  upon  the 
complicating  conditions  present. 

Course.— The  course  of  acute  anemia  is  short,  lasting  in  the 
majority  of  cases  only  a  few  hours.  In  the  chronic  form  the 
course  is  much  longer  lasting  for  several  weeks  or  months. 
In  this  case  the  course  will  depend  very  largely  upon  the 
cause  of  the  condition. 

Diagnosis. —The  diagnosis  does  not  present  any  difficulty. 
This  is  particularly  true  in  the  acute  form.  A  differential 
diagnosis  is  necessary  in  some  cases  to  distinguish  it  from 
diseases  of  the  heart,  or  leukemia.  In  the  former  the 
examination  of  the  heart  will  reveal  the  difference,  while  in 
the  latter  case  an  examination  of  the  blood  will  at  once  make 
clear  the  distinction  between  the  two  conditions. 

Prognosis.— The  acute  form,  providing  the  animal  does 
not  succumb  from  the  hemorrhage,  will  disappear  promptly. 
The  elements  of  the  blood  will  soon  be  normal  from  the 
drinking  of  large  quantities  of  water  and  ingesting  nutritious 
foods. 

In  the  chronic  form  the  prognosis  is  not  considered  very 
favorable.  It  will  depend  largely  upon  the  primary  factor 
producing  the  anemia.  A  careful  examination  should  be 
made  in  all  cases  to  determine  if  possible  the  actual  condi- 
tions. Many  patients  will  recover  completely  after  the 
elimination  of  the  causative  factor. 

Treatment.— In  acute  anemia  when  hemorrhage  is  taking 
place  an  attempt  should  be  made  to  arrest  it  at  once.  If  it  is 
21 


322  ANEMIA 

external,  the  vessels  should  either  be  ligated  or,  if  this  is 
impossible,  pack  the  wound  and  apply  a  bandage  to  compress 
the  vessels.  Internal  hemorrhage  may  be  controlled  by 
administering  hemostatics.  Adrenalin  chlorid  solution  (1- 
1000),  using  1-2  c.c.  intravenously.  This  may  be  repeated 
in  thirty  minutes  if  necessary.  Ergot  and  fluidextract  of 
hydrastis  may  also  be  used. 

Rectal  injections  of  normal  salt  solution  are  recommended. 
Inject  the  solution  as  high  up  into  the  rectum  as  possible. 
The  solution  should  be  at  or  near  the  body  temperature. 
Intravenous  injection  of  salt  solution  in  small  animals  is 
unsatisfactory.  In  the  chronic  form  determine  the  cause  of 
the  condition  if  possible  and  apply  treatment  to  correct  it. 

The  diet  is  an  important  thing  in  the  treatment  of  anemia. 
Foods  should  be  given  that  are  rich  in  protein.  Meat  and 
meat  scraps,  milk  and  eggs  have  proved  of  great  value. 
These  substances  should  be  given  frequently  and  in  small 
quantities  to  obtain  the  maximum  benefit.  Later  the  amount 
and  the  time  between  the  feeding  periods  can  be  increased. 
Numerous  medicinal  preparations  have  been  used,  but 
the  iron  compounds  have  given  the  best  results.  Iron 
and  quinin  citrate  in  doses  of  0.1-0.5  twice  daily  are  of 
great  value  as  a  general  tonic  and  alterative.  Reduced  iron, 
saccharated  carbonate  of  iron,  and  sulphate  of  iron  have  been 
used  successfully.  Small  doses  of  these  preparations  can  be 
given  for  a  few  weeks  if  necessary.  Fowler's  solution  of 
arsenic  in  doses  of  0.1-0.8  daily  is  excellent.  Carlsbad  salts 
should  be  given  in  small  doses  along  with  the  iron  prepara- 
tions. Good  hygienic  conditions  should  always  be  observed. 


LEUKEMIA. 

Definition.— A  disease  characterized  by  an  increase  in  the 
white  corpuscles,  together  with  changes  in  the  spleen,  lymph 
glands,  or  bone-marrow.  Two  forms  are  recognized,  viz.: 
(«)  Myelogenous,  and  (b)  lymphatic.  The  distinction  is 
based  on  whether  there  is  an  increase  in  the  leukocytes  or 
lymphocytes.  Combination  of  the  two  conditions  may  be 


LEUKEMIA  323 

found,  or  variations  and  degrees  of  either  of  the  two  forms 
may  be  present. 

Occurrence.— This  disease  occurs  most  frequently  in  dogs, 
occasionally  in  cats. 

Etiology.— Nothing  is  definitely  proved  relative  to  the 
cause  of  leukemia.  The  disease  is  probably  of  an  infectious 
origin,  but  experiments  conducted  along  this  line  have  given 
negative  results.  Toxic  agents  have  been  given  as  the 
cause,  as  have  injuries  and  various  other  factors. 

Pathology.— On  necropsy  in  leukemia  it  is  often  difficult 
to  make  a  distinction  between  the  two  forms  as  the  lesions 
of  both  occur  concomitantly  in  the  majority  of  cases.  It  is 
characterized  by  enlargement  of  the  spleen,  lymph  glands, 
liver,  kidneys  and  distinct  changes  in  the  marrow  of  the 
bones. 

The  spleen  is  enlarged  (in  some  instances  three  to  four 
times  its  normal  size),  dense  and  often  easily  torn.  Fre- 
quently nodules  are  seen  projecting  from  its  surface.  The 
color  is  dark  red,  and  on  cut  surface  dry,  and  shows  numer- 
ous whitish  colored,  enlarged  follicles  each  of  about  the  size 
of  a  wheat  grain.  The  stroma  of  the  gland  and  the  capsule 
are  thickened. 

The  lymph  glands  are  found  enlarged.  They  are  harder 
or  softer  than  normal,  of  a  whitish  or  gray  color,  sometimes 
showing  small  red  points  over  a  cut  surface.  The  surface 
when  scraped  gives  off  a  yellowish,  creamy  material.  The 
majority  of  lymph  glands  will  be  found  affected.  The  bone- 
marrow  is  of  a  dark  red  or  gray  color,  and  soft  consistency. 
On  examination  the  bone-marrow  will  be  found  very  rich  in 
white  corpuscles. 

The  liver  is  enlarged  and  shows  numerous  small  nodules 
of  lymphoid  tissue.  The  kidneys  are  enlarged  in  the  same 
manner.  Small  nodes  will  be  found  throughout  the  serous 
membranes,  lungs  and  other  tissues  in  the  body. 

Symptoms.— The  early  development  of  leukemia  is  usually 
not  observed.  Very  often  the  disease  is  not  recognized  until 
the  symptoms  become  prominent  and  it  has  reached  the 
advanced  stage.  The  early  symptoms  are  very  similar  to 
those  of  anemia,  and  the  differential  diagnosis  may  be  very 


324  ANEMIA 

difficult  until  decided  changes  take  place  either  in  the  blood 
or  lymphatic  system.  The  mucous  membranes  are  very 
pale  or  white  in  color,  the  animal  becomes  weak  and  edema- 
tous  swellings  may  appear.  The  enlargement  of  the  lymph 
glands  comes  on  gradually  and  is  found  involving  practically 
all  of  the  palpable  glands.  The  enlargements  vary  in  size, 
but  stand  out  in  some  cases  very  prominently.  The  glands 
are  firm,  non-painful  and  well  circumscribed  or  defined. 
The  glands  in  the  submaxillary  space,  at  the  pharynx,  chest 
and  inguinal  regions  show  most  enlargement.  The  move- 
ment of  the  animal  may  be  interfered  with  on  account  of  the 
increase  in  size  of  the  lymph  glands.  Respiratory  disturb- 
ances may  be  present  when  the  glands  become  large  enough 
to  compress  bloodvessels  or  nerves.  Extensive  edemas  are 
often  present  from  the  same  cause.  Ascites  is  a  common 
symptom  in  dogs  from  enlargement  of  the  mesenteric  glands. 
The  spleen  is  enlarged  but  difficult  to  palpate  on  account  of 
its  position;  the  enlargement  of  the  abdomen  may  be  the 
result  of  the  enlargement  of  the  spleen  or  liver,  or  both. 
Percussion  of  the  abdomen  may  assist  in  determining  the 
character  of  the  enlargement. 

Owing  to  the  involvement  of  the  bone-marrow  the  animal 
is  lame  and  shows  stiffness  and  soreness  in  movement. 
Pressure  on  the  long  bones  frequently  shows  marked  sensi- 
tiveness and  pain. 

Characteristic  alterations  are  found  in  the  blood.  It 
appears  pale  red,  or  even  brown,  indicating  a  reduction  in 
hemoglobin.  When  allowed  to  stand  and  coagulate  (which  it 
does  slowly)  it  separates  into  two  layers,  the  lower  consist- 
ing of  red  corpuscles,  while  the  upper  is  composed  of  white 
corpuscles  and  fibrin.  The  number  of  white  corpuscles  is 
always  increased;  in  some  cases  equal  in  number  to  the 
red  ones.  A  decrease  in  the  number  of  red  corpuscles  can 
be  demonstrated  in  most  cases.  A  differentiation  may  be 
made  between  the  two  forms  of  leukemia  by  the  blood 
examination.  In  lymphatic  leukemia  the  lymphocytes  are 
found  increased,  while  in  myelogenous  leukemia  the  leuko- 
cytes are  found  in  much  larger  numbers.  Clinically  the 
disease  develops  gradually,  emaciation  more  prominent,  and 


INFECTIOUS  LEUKEMIA  OF  CHICKENS  325 

more  or  less  extensive  hemorrhages  occur  in  the  various 
organs. 

Course.— The  disease  is  usually  chronic.  The  acute  form 
is  very  rare  in  small  animals.  The  course  usually  extends 
over  a  long  period,  and  complications  are  common. 

Diagnosis.— The  characteristic  involvement  of  the  lymph 
glands,  spleen  and  liver,  and  the  increase  in  the  number  of 
white  corpuscles,  will  make  the  diagnosis  comparatively 
easy.  A  microscopic  examination  of  the  blood  is  necessary 
in  order  to  make  the  diagnosis  accurate.  The  differentiation 
between  the  forms  of  leukemia  is  determined  definitely  in  this 
manner. 

Prognosis.— Very  unfavorable.  When  the  disease  -is  once 
established  there  is  little  hope  of  recovery. 

Treatment.— Owing  to  the  pathological  changes  present 
not  much  can  be  expected  in  the  way  of  treatment.  In  some 
cases  the  patient's  general  condition  may  be  improved  by 
allowing  plenty  of  nutritious  food  and  administering  altera- 
tives and  tonics.  Iron  and  quinin  citrate  (0.2  to  0.4  twice 
daily)  have  given  the  best  results.  Transfusion  of  blood 
has  proved  unsatisfactory  in  small  animals. 

INFECTIOUS  LEUKEMIA  OF  CHICKENS. 

Definition.— An  infectious  disease  of  chickens  probably 
produced  by  an  ultramicroscopic  virus.  It  is  characterized 
by  an  increase  in  the  number  of  leukocytes,  an  atrophy  of 
the  marrow  of  the  bones,  and  an  increase  in  the  size  of  the 
spleen  and  liver.  In  many  cases  the  number  of  red  blood 
corpuscles  is  reduced  and  the  white  ones  increased. 

Occurrence.— Up  to  the  present  time  the  disease  is  found 
only  in  chickens.  Other  fowls  are  not  affected.  It  often 
appears  in  an  enzootic  or  epizootic  form  when  large  numbers 
in  a  flock  or  community  will  be  affected. 

Etiology.— From  rather  extensive  investigations  made 
with  this  disease  it  is  evidently  due  to  a  virus  found  in  the 
affected  organs,  viz.:  The  spleen,  lymph  glands,  and  bone- 
marrow.  The  disease  is  easily  transmitted  by  intraperi- 
toneal  or  intravenous  injections,  while  subcutaneous  injec- 


326  ANEMIA 

tions  prove  negative.  Animals  other  than  chickens  are  not 
susceptible  to  the  disease. 

Pathogenesis. — The  method  of  development  of  infectious 
leukemia  has  not  been  definitely  proved.  The  virus  of  the 
disease  by  irritation  produces  an  increase  in  the  number  of 
white  blood  cells  in  the  capillaries  of  the  spleen,  bone-marrow 
and  liver. 

Pathology.— The  most  pronounced  lesions  are  found  in  the 
spleen,  liver  and  marrow  of  the  bones.  The  spleen  and 
liver  are  much  enlarged,  and  the  bone-marrow  reddened  and 
congested.  The  lymph  glands  are  also  enlarged  occasionally. 
The  blood  is  lighter  in  color  than  normal  (less  hemoglobin) 
and  contains  a  larger  proportion  of  leukocytes  than  normally. 
General  anemia  is  apparent  by  the  wasted  tissues. 

Symptoms.—  The  period  of  incubation  is  approximately 
thirty  to  sixty  days.  The  disease  develops  very  slowly  and 
insidiously.  Some  cases  may  assume  an  acute  form,  the 
birds  succumbing  in  about  two  weeks.  The  early  indications 
are  anemia  as  indicated  by  the  paleness  of  the  comb  and 
wattles  and  a  decided  loss  in  weight.  Later  as  the  disease 
continues  there  is  a  tendency  for  hemorrhages  to  take  place 
even  from  slight  wounds,  indicating  a  hemorrhagic  diathesis. 

Examination  of  the  blood  reveals  the  true  condition. 
There  will  be  found  a  great  increase  in  white  corpuscles  and 
a  material  reduction  in  the  number  of  red.  The  latter  may 
be  reduced  to  one-fourth  their  normal  number.  The  hemo- 
globin content  of  the  blood  is  also  reduced  giving  it  a  pale 
color  and  reducing  its  staining  properties. 

The  condition  when  chronic  develops  gradually  and  the 
chicken  often  dies  from  exhaustion. 

Course.  —The  course  of  the  disease  is  quite  variable.  Many 
cases  apparently  run  a  very  rapid  course  after  the  appearance 
of  the  first  symptoms,  lasting  from  one  to  three  weeks. 
Others  may  linger  longer  or  from  one  to  four  months. 

Diagnosis. — The  diagnosis  can  be  established  only  by 
necropsy  and  a  microscopic  examination  of  the  blood  to  deter- 
mine the  ratio  of  the  white  to  the  red  corpuscles.  Differen- 
tial diagnosis  may  be  difficult,  but  considering  the  lesions 


PSEUDOLEUKEMIA—HODGKIN'S  DISEASE         327 

and  the  fact  that  a  number  of  fowls  may  be  affected  at  the 
same  time,  assist  in  arriving  at  the  diagnosis. 

Prognosis.— Very  unfavorable.     Recoveries  are  very  rare. 

Treatment. — No  treatment  has  proved  of  any  value.  Dis- 
infection of  the  premises  and  destruction  of  all  affected  birds 
are  advisable. 

PSEUDOLEUKEMIA.     HODGKIN'S  DISEASE. 

Definition.— A  disease  characterized  by  a  progressive 
enlargement  of  the  blood-forming  organs  (spleen,  liver, 
lymphatic  glands)  and  nodular  growths  in  these  and  other 
organs.  It  resembles  leukemia  in  many  respects.  A 
notable  exception  is  that  the  white  corpuscles  are  not 
increased  as  in  leukemia. 

Occurrence.— The  disease  appears  most  commonly  in  dogs, 
cats  and  chickens.  It  is  more  common,  however,  in  dogs  and 
chickens  than  leukemia. 

Etiology.— The  true  character  of  the  disease  is  not  known. 
The  etiological  factors  are  believed  by  some  authorities  to  be 
identical  with  leukemia.  Others  are  not  in  accord  with  this 
belief. 

Pathology.— The  lesions  found  in  pseudoleukemia  resemble 
very  much  those  found  in  true  leukemia.  Enlargement  of 
the  spleen,  liver  and  lymph  glands  is  observed  in  most  cases. 

Symptoms.— Progressive  anemia  and  enlargement  of  the 
lymph  glands  are  the  prominent  early  symptoms.  Examina- 
tion of  the  blood  will  show  that  the  ratio  between  the  red 
and  white  corpuscles  is  nearly  normal.  Other  symptoms  are 
practically  the  same  as  in  leukemia. 

Diagnosis.— A  diagnosis  can  be  made  only  by  a  micro- 
scopic examination  of  the  blood.  It  should  be  differentiated 
from  leukemia,  malignant  tumors  and  tuberculosis. 

Prognosis . — I  'nf  a  vorable . 

Treatment.  —Treatment  is  unsatisfactory.  Iron  and  quinin 
citrate  (0.2  to  0.4  twice  daily),  or  Fowler's  solution  of  arsenic 
(0.2  to  0.6  once  daily)  may  be  tried.  Potassium  iodid  in 
small  doses  is  also  recommended. 


328  ANEMIA 

HEMOPHILIA. 

A  constitutional  defect  in  which  there  is  a  tendency  for 
uncontrollable  hemorrhage  from  slight  wounds.  It  may 
occur  after  slight  injuries,  congestions,  or  apparently  spon- 
taneously. The  coagulation  of  the  blood  is  retarded  or 
absent.  Hemophilia  is  very  rare  in  animals.  For  further 
information  the  reader  is  referred  to  other  works. 

SCURVY.     SCORBUTUS. 

Definition.— A  disease  characterized  by  marked  debility 
and  weakness,  spongy  and  ulcerative  condition  of  the  gums 
with  bleeding  and  a  tendency  to  hemorrhage  in  the  various 
organs. 

Occurrence.— Scurvy  is  not  very  common  in  animals.  A 
few  cases  have  been  found  in  dogs.  Ulcerative  stomatitis  is 
often  mistaken  for  true  scorbutus. 

Etiology.— There  are  several  factors  which  contribute  to 
the4  production  of  this  disease,  viz.:  (a)  The  diet,  when 
restricted  to  certain  foods  for  a  comparatively  long  time, 
will  produce  the  disease  by  disturbing  general  metabolism, 
the  body  being  deprived  of  food  elements  necessary  for  its 
normal  maintenance.  (6)  Unsanitary  conditions,  such  as 
damp  cellars,  badly  kept  kennels,  exposure  to  cold  and 
dampness  are  important  predisposing  causes,  (c)  One  of 
the  most  important  causes  in  dogs  is  ptomain  poisoning, 
resulting  from  eating  spoiled  meats,  fish,  etc.  (d)  There  is 
some  question  as  to  the  disease  being  produced  by  infection. 
Infection  is,  of  course,  a  possible  cause. 

Pathology.— Small  hemorrhages  are  found  in  the  tissues 
and  organs  of  the  body.  These  are  most  noticeable  under 
the  skin,  in  the  muscles,  on  mucous  and  serous  membranes, 
in  the  joints,  liver,  spleen  and  kidneys.  Along  the  margin 
of  the  gums  will  be  found  distinct  ulcerative  processes. 
The  gums  are  dark,  almost  black,  or  reddened,  and  show 
separation  from  the  teeth.  Shreds  of  the  membrane  may  be 
removed  easily  with  the  forceps.  The  spleen  is  enlarged  and 
of  a  soft  consistency.  The  lymph  glands  of  the  mesentery 


SCURVY— SCORBUTUS  329 

are  enlarged  and  congested.  Changes  in  the  blood  may 
leave  it  thin  and  pale  in  color. 

Symptoms.— Anemia  and  emaciation  are  early  symptoms 
of  the  disease.  The  patient  becomes  very  languid,  and  does 
not  care  to  exercise  or  move  about.  The  appetite  is  sup- 
pressed either  partially  or  completely,  and  the  thirst  is 
increased.  Marked  changes  are  observed  on  the  visible 
mucous  membranes,  those  of  the  mouth  showing  the  most 
pronounced  lesions.  The  mucous  membrane  around  the 
margin  of  the  gums  becomes  discolored  red,  later  dark 
bluish-red,  and  even  almost  black.  Hemorrhages  are  present 
in  many  cases,  or  the  least  manipulation  of  the  gums  causes 
bleeding.  The  membranes  become  swollen  and  very  sensitive 
to  the  touch.  The  patient  when  eating  will  often  stop 
abruptly  and  show  marked  pain  from  the  food  irritating  the 
involved  membranes.  Distinct  ulcerative  processes  are 
observed  in  the  later  stages,  the  gingival  membrane  becoming 
separated  from  the  teeth  and  often  the  teeth  themselves 
become  loose  and  fall  out.  Hemorrhages  are  also  found  on 
the  conjunctiva!  membranes,  in  the  nasal  passages,  and  under 
the  skin. 

Vomiting  is  a  common  symptom.  The  vomited  stomach 
contents  are  often  mixed  with  blood  indicating  gastric 
hemorrhage.  Bowel  discharges  may  also  contain  blood. 
The  disease  is  progressive  and  the  symptoms  increase  in 
intensity  until  the  animal  is  exhausted  or  some  complication, 
such  as  septicemia,  pneumonia,  or  extensive  hemorrhage 
develops. 

Diagnosis.— A  differential  diagnosis  is  necessary  in  dogs  in 
order  to  distinguish  scurvy  from  ulcerative  stomatitis.  The 
main  points  of  difference  are:  (a)  The  absence  of  general 
symptoms  and  hemorrhages  in  ulcerative  stomatitis,  (b) 
The  localization  of  the  condition  in  ulcerative  stomatitis, 
while  in  scurvy  other  parts  of  the  body  are  affected.  In 
long-standing  cases  of  ulcerative  stomatitis  the  differentiation 
may  be  somewhat  difficult. 

Prognosis.— This  will  depend  a  great  deal  upon  the  progress 
the  disease  has  made.  If  the  cause  can  be  removed  in  the 
very  early  stages,  the  prognosis  is  more  favorable  than  in 


330  ANEMIA 

cases  where  the  ulcerative  processes  are  well  established. 
When  general  symptoms  of  anemia  and  cachexia  are  evident 
the  prognosis  is  bad. 

Treatment. — This  disease  can  be  readily  prevented  when  a 
variety  of  food  is  allowed  and  good  sanitary  conditions 
prevail. 

The  early  indications  in  the  treatment  are  to  change  and 
regulate  the  diet.  Give  the  patient  nourishing  food,  such 
as  meat,  milk,  eggs,  etc.  Iron  preparations  (iron  and 
quinin  citrate,  pulverized  iron,  saccharated  carbonate  of 
iron)  are  the  most  satisfactory  for  the  anemia  which  is  nearly 
always  present.  Tincture  of  nux  vomica  (0.3  to  0.5  daily) 
or  tincture  of  gentian  (0.5  to  0.8  twice  daily)  is  useful  as  a 
tonic. 

Local  applications  should  also  be  used.  Swab  the  gums 
and  other  affected  mucous  membranes  of  the  mouth  with 
tincture  of  myrrh  once  or  twice  daily. 

When  hemorrhages  are  present  they  must  be  controlled 
by  appropriate  treatment. 

ANIMAL  PARASITES  IN  THE  BLOOD. 

Filaridoe.    Mdastrongulincp. 

Several  species  of  animal  parasites  have  been  found 
infesting  the  blood  and  circulatory  organs  in  small  animals. 
The  dog  is  most  frequently  affected.  In  several  districts  of 
the  United  States,  Canada  and  Mexico,  the  condition  has 
been  reported  a  number  of  times.  The  Dirofilaria  immitis, 
Hematozoon  Lewisi,  Hsemostrongylus  vasorum  and  the  Spi- 
roptera  sanguinolenta  are  the  most  important  ones  found. 

Dirofilaria  immitis  (Filaria  immitis}.— Occurrence.—  This 
blood  affection  has  been  observed  very  commonly  in  the 
dog,  particularly  in  Japan,  China,  and  in  some  sections  of 
North  and  South  America.  The  United  States  is  fairly  free 
from  the  infestation,  but  it  is  quite  possible  that  many  cases 
have  been  overlooked. 

Etiology.— The  Dirofilaria  immitis  is  a  long,  white  worm, 
the  male  being  12  to  18  cm.,  and  the  female  20  to  30  cm.  long 


ANIMAL  PARASITES  IN   THE  BLOOD  331 

The  posterior  portion  of  the  male  parasite  shows  a  curvature 
or  spiral  bending.  The  female  gives  birth  to  living  embryo. 

The  mature  parasites  live  in  heart  (right  half)  in  the  major- 
ity of  infestations.  The  left  heart  and  bloodvessels  harbor 
them  in  some  cases.  The  number  of  parasites  vary  from  a 
few  to  several  hundred.  They  are  usually  found  entangled 
in  a  round  ball-like  mass.  The  females  give  birth  to  embryos 
which  are  each  about  j  mm.  long,  and  are  set  free  in  the  blood 
in  large  numbers.  The  sexually  mature  parasites  may  be 
found  at  the  same  time  in  other  parts  of  the  body.  The 
manner  in  which  infestation  takes  place  has  not  been  fully 
proved.  It  is  probably  from  the  drinking  water  which 
contains  the  larvae.  These  embryos  reach  the  heart  before 
they  mature.  They  may  be  discharged  from  the  animal 
either  in  the  urine,  nasal  discharge,  blood,  or  with  the  feces 
and  contaminate  food  or  water  again. 

Pathogenesis.— The  mature  parasites  located  as  they  are 
in  the  heart  or  large  vessels  produce  more  or  less  of  a  mechan- 
ical disturbance  in  the  action  of  those  organs,  or  direct  inter- 
ference in  the  flow  of  blood  through  them.  Formation  of 
emboli  in  the  vessels,  which  often  results,  brings  on  various 
complications  in  part  due  to  necrotic  foci  in  the  lungs  or  other 
organs.  The  presence  of  the  embryos  in  the  blood  ultimately 
leads  to  anemia  with  leukocytosis. 

Pathology.— On  necropsy  the  right  heart  is  usually  found 
to  be  partially  or  completely  filled  with  the  parasites  sur- 
rounded by  a  coagulated  mass  of  blood.  The  endocardium 
is  found  more  or  less  thickened  and  inflamed.  The  heart 
is  often  dilated,  the  walls  thin,  and  some  cases  ruptured. 
Very  frequently  the  lungs  show  small  foci  of  necrosis,  or 
nodules  in  the  center  of  which  embryos  are  found.  Similar 
lesions  occur  in  the  liver,  kidneys,  skin  and  muscular  tissues. 
General  anemia  is  present. 

Symptoms.— The  symptoms  will  depend  a  great  deal  upon 
the  number  of  adult  parasites  and  embryos  infesting  the 
circulatory  system.  When  small  numbers  are  present  the 
animal  may  not  show  any  particular  manifestations.  When 
the  number  is  great,  anemia  and  marked  emaciation  develop. 
Hemorrhages  are  proved  to  appear  in  the  mucous  membranes, 
skin,  lungs,  intestinal  tract  and  other  organs. 


332  ANEMIA 

Various  complications  will  be  observed  from  the  emboli 
affecting  the  different  functions  in  the  body.  The  most 
pronounced  complicating  symptoms  are  in  connection  with 
the  heart,  lungs  and  brain.  The  blood  shows  evidence  of 
anemia  and  leukocytosis.  There  is  absence  of  fever,  and  a 
gradual  progressive  anemia  which  may  continue  for  several 
months. 

Diagnosis. — A  correct  diagnosis  can  be  made  only  by  a 
microscopic  examination  of  the  blood  for  embryos.  These 
are  easily  recognized  by  their  shape  and  peculiar  snake-like 
movements. 

Treatment.— Very  little  can  be  done  in  the  way  of  treat- 
ment. Nutritious  food  and  iron  preparations  are  recom- 
mended. Atoxyl  in  small  doses  has  been  used  successfully 
to  reduce  the  number  of  embryos  in  the  blood. 

Complicating  symptoms  are  treated  as  they  develop. 

Hematozoon  Lewis!.— This  parasite  is  found  infesting  the 
circulatory  system  in  much  the  same  manner  as  the  Diro- 
filaria  immitis.  Dogs  are  most  commonly  affected.  A  micro- 
scopic examination  of  the  blood  is  necessary  in  order  to 
establish  the  diagnosis.  The  embryos  attach  their  heads 
to  the  cover-glass  and  move  their  bodies  very  rapidly  when 
viewed  under  the  microscope.  Little  is  known  concerning 
the  life  history  of  this  parasite.  It  is  supposed  to  be  taken 
into  the  body  from  fleas  and  lice  in  which  the  larvse  of  this 
parasite  have  been  found. 

Treatment  is  the  same  as  for  Dirofilaria  immitis. 

Haemostrongylus  vasonun. —This  is  a  fine,  thread-like  worm 
infesting  the  right  ventricle  of  the  heart  and  the  pulmonary 
artery  and  its  branches.  The  male  parasite  is  about  13-16 
mm.  long,  and  the  female  17-20  mm.  It  forms  small  nodules 
in  the  lining  membrane  of  the  vessel  wall  and  thrombi  in  the 
smaller  vessels.  The  female  parasite  lays  eggs  which  lodge 
in  the  finer  vessels,  which,  like  the  embryos,  lead  to  the 
formation  of  small  nodes.  The  embryos  migrate  into  the 
bronchi  and  are  coughed  up  and  taken  in  by  other  animals. 

Symptoms.— The  symptoms  are  mostly  those  of  a  progres- 
sive anemia  and  are  not  characteristic. 


ANIMAL  PARASITES  IN  THE  BLOOD  333 

Diagnosis.— The  diagnosis  is  only  made  by  finding  the 
parasites  on  autopsy  or  the  eggs  and  embryos  in  the  expecto- 
ration or  blood. 

Treatment. —Unsatisfactory . 

Spiroptera  sanguinolenta.  —  This  is  a  small,  thread-like 
worm  found  in  different  parts  of  the  body,  but  more  particu- 
larly in  the  heart  and  large  arterial  branches.  It  is  of  minor 
importance  as  the  infestation  is  of  rare  occurrence  in  small 
animals.  The  symptoms  are  those  of  anemia  and  heart 
weakness  and  are  not  characteristic.  A  microscopic  exami- 
nation or  a  necropsy  is  necessary  in  order  to  confirm  the 
diagnosis. 


CHAPTER   II. 
DISEASES  OF  THE  THYROID  GLANDS. 

Examination  and  General  Consideration.— Diseases  involving 
these  glands  are  of  considerable  importance  in  dogs  in  which 
animals  all  forms  of  goiter  are  found.  Other  small  animals 
are  very  seldom  affected.  The  two  thyroid  glands,  one  on 
either  side  of  the  neck,  are  situated  in  the  upper  third  of  the 
cervical  region.  They  are  normally  small  but  easily  palpable. 
When  diseased  they  usually  grow  larger  and  tend  to  descend 
downward  toward  the  thoracic  inlet.  The  position  of  the 
diseased  glands  will  vary,  therefore,  with  their  size  and  the 
breed  of  dog. 

An  important  thing  to  be  considered  in  connection  with 
the  thyroid  glands  is  the  presence  of  small  glandules  closely 
related  to  them.  These  glandules  are  often  found  in  close 
contact  with  the  thyroid  glands  occurring  in  the  adjacent 
tissue  or  they  may  be  quite  a  distance  removed  from  them. 
They  consist  of  small,  nodular  glands,  composed  of  true 
thyroid  or  lymphoid  tissue,  and  are  considered  accessory 
glands  to  the  thyroids.  Normally  they  are  very  small, 
but  usually  become  much  enlarged  when  the  thyroid  glands 
are  involved.  These  small  glandules  seem  to  be  closely 
associated  with  the  thyroid  glands  in  function,  and  will 
replace  to  a  certain  degree  the  secretions  necessary,  when  the 
true  glands  are  diseased  or  destroyed. 

CONGESTION  OF  THE  THYROID  GLANDS. 

At  or  near  the  time  of  puberty  the  glands  are  often  found 
enlarged;  during  the  estrual  periods  the  same  condition  is 
commonly  observed.  This  temporary  congestion  will  disap- 
pear in  a  few  days  in  the  majority  of  cases  and  the  glands 


ACUTE  THYROIDITIS  335 

assume  their  normal  size  and  condition.  A  temporary  con- 
gestion may  also  occur  from  collars  being  too  tight,  or  dogs 
pulling  on  the  leash,  which  disturbs  the  circulation  in  the 
glands.  Swelling  of  one  or  both  glands  may  result  from  this 
and  last  for  several  days  simulating  goiter.  As  soon  as  the 
cause  is  removed  the  circulation  will  return  to  its  normal 
state  and  the  congestion  gradually  disappear.  Direct 
injuries  to  the  glands  are  not  uncommon  and  congestion  and 
edema  result.  Examination  will  often  reveal  the  presence 
of  a  wound  or  a  contused  area.  Permanent  enlargement  of 
one  or  both  glands  may  result  from  injuries,  due  to  fibrous 
formation. 

ACUTE  THYROIDITIS. 

Definition. — An  acute  inflammation  of  one  or  both  thyroid 
glands.  This  condition  has  been  observed  in  dogs. 

Etiology.— The  majority  of  cases  are  secondary  to  other 
diseases,  such  as  distemper,  local  infection  in  the  adjacent 
tissue,  or  from  direct  injuries. 

Symptoms.— The  glands  are  first  noticed  to  be  prominent, 
enlarged,  sensitive  on  palpation,  and  the  local  temperature 
elevated.  In  severe  congestion  the  gland  will  often  show 
pulsation.  A  differentiation  should  be  made  between  this 
condition  and  the  various  forms  of  goiter.  The  sudden 
development,  local  heat,  and  marked  reaction  in  the  glands 
will  assist  in  making  the  differentiation.  The  history  of 
the  condition  following  distemper  or  injuries  should  also  be 
taken  into  consideration  in  making  the  diagnosis. 

Prognosis.— The  termination  of  acute  thyroiditis  is  usually 
favorable.  The  inflammation  subsides  and  the  gland  resumes 
its  normal  function.  Some  few  cases  terminate  in  a  degenera- 
tion and  suppurative  condition  which  may  destroy  a  part 
or  the  whole  gland.  It  is  possible  also  to  have  the  condition 
become  chronic  and  produce  a  firm  fibrous  growth  simulating 
some  forms  of  goiter. 

Treatment.  — During  the  acute  stage  cold  applications 
should  be  applied  either  in  the  form  of  cold  water  or  ice  packs. 
This  followed  by  a  hot  Priessnitz  compress  and  continued 
until  resolution  takes  place  or  degeneration  and  abscess 


3.36  DISEASES  OF  THE  THYROID  GLANDS 

formation  occur.  Should  the  function  of  the  gland  be 
disturbed  for  a  prolonged  period  either  potassium  iodid  in 
small  doses  or  thyroid  extract  has  proved  to  be  of  consider- 
able value.  When  abscesses  occur  they  should  be  opened, 
drainage  effected,  and  an  iodin  pack  applied. 

GOITER.     STRUMA.     BRONCHOCELE. 

Definition.— A  hypertrophy  or  enlargement  of  the  thyroid 
glands  which  occurs  sporadically.  It  is  very  frequent  in 
dogs.  In  some  instances  goiter  is  congenital  and  whole 
litters  of  puppies  are  affected.  The  enlargement  of  the 
glands  in  these  cases  may  be  of  sufficient  size  to  interfere 
seriously  with  parturition.  Very  often  the  glands  will  be 
six  to  ten  times  larger  than  normal,  seemingly  as  large  as 
the  puppy  itself.  The  lobes  and  isthmus  of  the  glands  are 
so  intermingled  that  no  distinction  can  be  made  between 
them,  the  whole  forming  one  large  mass  in  the  inferior  cervical 
region. 

The  disease  is  also  acquired  in  a  great  many  cases,  coming 
on  at  different  periods  in  the  development  of  individual 
animals. 

Occurrence.— The  occurrence  of  goiter  in  the  various  breeds 
of  dogs  seems  to  be  in  about  the  same  ratio,  although  in 
certain  districts  pointers,  bull  dogs,  and  bull  terriers,  seem 
to  be  affected  in  larger  numbers  than  other  breeds. 

Many  forms  of  goiter  are  recognized  in  dogs,  viz.:  (a) 
Parenchymatous;  (6)  cystic;  (c)  fibrous;  (d)  vascular;  (e) 
malignant;  (/)  exophthalmic. 

Parenchymatous  Goiter.— Definition.— A  diffuse  paren- 
chymatous  enlargement  of  the  gland  with  an  increase  in  the 
stroma  and  a  collection  of  gelatinous  colloid  material  in  the 
follicles. 

Occurrence.— This  form  is  by  far  the  most  common  and 
occurs  more  frequently  in  puppies  or  young  dogs. 

Symptoms.— The  first  symptom  noticed  is  the  enlargement 
of  one  or  both  thyroid  glands.  The  enlargement  may  not 
be  equal  in  both  glands.  One  is  frequently  much  larger 
than  the  other.  This  form  of  goiter  often  develops  suddenly 


GOI TER—STR  UMA—BROXCHOCELE  337 

and  the  glands  assume  enormous  proportions.  Puppies  are 
often  born  with  this  particular  form  or  develop  it  during 
the  first  few  weeks  of  their  lives.  In  many  cases  no  marked 
symptoms  of  any  general  disturbance  are  observed,  the 
animal  developing  apparently  normal  except  the  presence 
of  the  enlarged  thyroid  glands.  In  other  cases,  when  the 
glandular  secretion  is  materially  interfered  with,  cretinism 
and  myxedema  are  prominent  symptoms.  This  is  evidenced 
by  marked  nervous  disturbances  and  degeneration  of  the 
various  tissues  in  the  body.  The  animal  becomes  emaciated, 
weak,  a  mere  shadow  of  its  former  condition.  Young  animals 
as  a  result  of  this  glandular  disturbance  do  not  develop 
normally,  the  head  may  be  larger  than  normal,  and  other 
parts  of  the  body  undeveloped,  or  vice  versa.  Respiratory 
disturbances  often  result  from  the  enlarged  glands  pressing 
upon  the  trachea,  or  from  compression  of  the  vagus  and 
sympathetic  nerves.  The  latter  condition  no  doubt  accounts 
for  the  larger  number  of  cases  in  which  labored  respiration 
and  spasm  of  the  glottis  are  prominent  symptoms.  Hemi-r 
plegia  laryngis  is  produced  in  a  similar  manner  by  pressure 
on  the  recurrent  nerve.  Circulatory  irregularities  are  not  so 
common  in  parenchymatous  goiter.  Direct  examination  of 
the  glands  will  reveal  the  enlargement,  its  smooth  regular 
outline,  moderately  firm  consistency,  and  absence  of  local 
heat  or  pain.  The  isthmus  of  the  glands  can  be  palpated, 
except  when  the  glands  are  greatly  enlarged.  In  many 
cases  no  general  symptoms  of  deranged  appetite,  elevation 
of  temperature,  or  cachexia  will  be  noticed. 

Diagnosis.— The  diagnosis  of  goiter  in  general  is  quite  easy, 
but  in  some  cases  it  is  difficult  to  make  a  definite  distinction 
between  the  various  forms.  Goiter  should  be  differentiated 
from  abscess,  hematoma,  and  various  cyst  formations.  This 
can  be  done  as  a  rule  very  easily  after  carefully  palpating 
the  enlargement.  In  order  to  make  a  positive  diagnosis  of 
the  variety  or  form  of  goiter  present,  it  is  necessary  to 
consider  the  character  of  the  enlargement,  its  consistency, 
the  condition  and  age  of  the  animal.  Palpation  of  the  glands 
to  determine  their  form,  whether  regular  and  smooth,  or 
irregular  and  lobulated,  and  their  consistency,  is  a  very 

22 


338  DISEASES  OF  THE  THYROID  GLANDS 

important  means  of  making  the  differentiation  between  the 
various  forms  of  goiter. 

Prognosis.— In  parenchymatous  goiter  most  cases  recover. 
The  glands  grow  smaller  until  of  normal  size  or  near  it,  and 
any  general  symptoms  disappear.  However,  in  cases  where 
the  glands  are  enormously  enlarged  and  symptoms  of  cretin- 
ism and  myxedema  are  present  the  prognosis  is  not  favorable. 
A  recurrence  of  this  form  of  goiter,  while  rare,  is  always 
probable. 

Treatment.— lodin  medication  both  externally  and  inter- 
nally has  proved  to  be  of  great  value.  Some  remarkable 
results  have  been  obtained  in  the  rapidity  and  degree  of 
reduction  after  its  use.  For  internal  administration  it  has 
been  definitely  proved  that  small  doses  give  the  best  results. 
The  dose  should  be  regulated  somewhat  according  to  the  age 
and  size  of  the  animal.  One-fourth  grain,  0.016  of  potassium 
iodid  for  puppies,  or  0.05-0.08  for  older  animals,  given 
once  daily,  has  given  the  best  results.  When  given  in  large 
doses  there  is  danger  of  too  rapid  depletion  of  the  body  and 
paralysis  of  the  heart.  These  small  doses  should  be  continued 
daily  for  one  to  three  weeks.  For  external  application  color- 
less tincture  of  iodin  may  be  applied.  Where  staining  the 
hair  does  not  matter  the  regular  tincture  should  be  employed. 
An  application  can  be  made  daily,  or  every  second  day. 
Thyroid  extract  (0.15  daily)  has  been  used  with  excellent 
results.  Surgical  interference  has  not  proved  successful 
in  relieving  this  form  of  goiter.  Complete  unilateral 
thyroidectomy  might  be  tried  in  case  one  gland  is 
enormously  enlarged  and  the  other  nearly  normal.  The 
operation  is  performed  under  general  anesthesia  and  strict 
antiseptic  precautions.  The  gland  is  dissected  out  carefully 
and  multiple  ligation  of  the  pedicle  is  necessary  so  that  the 
tissue  will  not  retract  and  allow  the  ligature  to  slip  off.  The 
gland  is  then  removed  about  ^  inch  from  the  ligature  and  the 
wound  packed  with  antiseptic  gauze  for  a  few  days.  The 
ligature  is  then  removed  cautiously  and  the  wound  covered 
with  an  antiseptic  dusting  power.  It  is  very  important  that 
the  wound  be  kept  free  from  infection  during  the  first  few 
days,  and  the  ligature  kept  in  position  to  avoid  fatal  hemor- 
rhage. 


GOI TER—STR  UMA—BRONCHOCELE  339 

Cystic  Goiter.— Definition.— An  enlargement  of  one  or 
both  thyroid  glands,  characterized  by  the  formation  of  cysts 
which  may  be  single  or  multiple.  In  cases  of  long  standing, 
calcification  of  the  cyst  wall  may  take  place.  The  cause  of 
cystic  goiter  has  never  been  clearly  proved.  When  hemor- 
rhage occurs  in  the  gland  follicles  they  are  distended,  certain 
changes  in  the  contents  result,  and  there  is  left  a  more  or 
less  clear  serous  fluid.  Further,  through  disturbance  in  the 
glandular  activity,  from  injury,  nervous  influences,  or  hyper- 
emia,  the  circulation  of  the  glands  is  abnormal  leading  to 
extravasation  of  serum  into  the  follicles  which  may  result 
in  a  permanent  cystic  condition.  Cysts  commonly  compli- 
cate parenchymatous  goiter. 

Symptoms. — An  enlargement  of  one  or  both  of  the  thyroid 
glands  is  the  most  prominent  symptom.  Many  cases 
develop  rather  suddenly  while  others  require  considerable 
time  before  the  glands  reach  a  sufficient  size  to  become 
noticeable.  As  a  rule,  unless  complicated  with  other  forms 
of  goiter,  no  general  symptoms  will  be  present.  Should  the 
cystic  formation  involve  both  glands  it  is  quite  possible  that 
the  normal  function  of  the  glands  will  be  disturbed,  then 
general  symptoms  will  result.  Pressure  on  the  vagus,  sym- 
pathetic, and  recurrent  nerves  may  lead  to  complications 
as  in  parenchymatous  goiter.  In  the  majority  of  cases  the 
course  of  this  goiter  is  chronic,  and  aside  from  the  unsightly 
enlargement  they  produce,  the  animal  will  not  suffer  any 
inconvenience.  Examination  of  the  gland  by  careful  palpa- 
tion will  reveal  the  soft,  fluctuating  swelling,  the  absence  of 
inflammation,  and  a  consistency  differing  from  other  forms  of 
goiter. 

Diagnosis.— The  diagnosis  can  be  made  positive  by  the 
examination,  and  if  necessary  by  the  use  of  an  exploring  trocar 
to  obtain  some  of  the  yellowish  or  clear  serous  fluid. 

Prognosis.— Favorable  when  proper  and  prompt  treatment 
is  used.  Further,  as  this  is  in  most  cases  a  local  condition 
confined  to  the  gland,  remedial  measures  can  be  applied  more 
satisfactorily. 

Treatment.— This  is  of  two  kinds,  viz.:  (a)  Medical,  and 
(b)  surgical. 


340  DISEASES  OF   THE  THYROID  GLANDS 

Medical.— Medical  treatment  in  the  form  of  potassium 
iodid  (0.03-0.06)  is  of  value  to  assist  in  replacing  the  loss 
in  the  normal  secretion  of  the  gland,  especially  when  both 
glands  are  extensively  involved.  Thyroid  extract  in  0.15 
doses  daily  can  also  be  used. 

Surgical. — This  consists  in  either  aspirating  the  serous 
fluid  from  the  cystic  follicles  and  injecting  a  small  amount 
of  Lugol's  solution  to  stop  further  filling  up,  or  opening  the 
cysts  and  packing  the  cavity  temporarily  with  iodin  gauze. 
After-treatment  consists  in  the  use  of  antiseptics.  The  wound 
will  heal  leaving  but  slight  enlargement. 

Fibrous  Goiter.— Definition.— An  enlargement  usually  of 
one  of  the  thyroid  glands  (rarely  both)  characterized  by  a 
hypertrophy  of  the  stroma  and  an  atrophy  of  the  glandular 
tissue.  It  is  most  frequent  in  old  animals.  This  form  of 
goiter  results  in  most  cases  from  injuries,  acute  and  chronic 
inflammation,  and  in  a  few  cases  no  doubt  from  some  of  the 
other  forms  of  goiter.  The  interstitial  tissue  is  gradually 
increased  exerting  abnormal  pressure  on  the  gland  substance, 
which  leads  to  pressure  atrophy. 

Symptoms.— The  presence  of  the  enlargement  confined  in 
most  cases  to  one  gland.  Occasionally  both  glands  will  be 
found  affected.  The  size  of  the  enlargement  varies  greatly 
from  very  slight  to  extreme  thickening  of  the  entire  intersti- 
tial tissue.  No  general  symptoms  are  observed  in  the  major- 
ity of  cases  as  it  is  confined  to  one  gland  and  of  long  standing. 
When  both  glands  are  extensively  involved,  interfering  with 
the  function  of  the  glands,  emaciation,  weakness  and  general 
cachexia  may  be  prominent  symptoms.  Respiratory  and 
other  disturbances  are  only  observed  when  the  enlargement 
presses  on  the  trachea  or  nerves. 

On  palpation  of  the  gland  it  will  be  found  exceedingly 
firm,  resistant,  smooth  in  outline,  non-inflammatory,  and 
non-sensitive.  The  isthmus  of  the  gland  is  easily  determined. 

Diagnosis.— This  should  not  be  difficult  as  the  outline  of 
the  enlargement  and  the  hard,  firm  consistency,  with  the 
other  symptoms,  are  characteristic  of  fibrous  goiter. 

Prognosis.— Favorable.  Many  cases,  when  not  exceed- 
ingly large,  are  not  treated  as  they  cause  but  little  incon- 


GO  I TER—STR  UMA—BRO  \CHOC  ELK  341 

venience  to  the  animal.  Reduction  in  the  size  of  the  gland 
is  possible,  or  it  can  be  extirpated. 

Treatment.— Injections  of  iodin  into  the  gland  substance 
have  given  good  results.  Inject  iodin  tincture  (2.0  to  5.0) 
into  the  gland  being  careful  to  avoid  introducing  the  needle 
directly  into  a  bloodvessel.  The  needle  should  be  inserted 
unattached  to  determine  this  fact  before  the  injection  is 
made.  The  injections  may  be  repeated  after  the  acute 
symptoms  subside.  It  is  sometimes  necessary  to  make 
several  applications  before  reduction  is  complete.  Extirpa- 
tion of  the  enlarged  gland  is  recommended  when  of  consid- 
erable size  and  the  fellow  gland  normal.  The  operation  is 
performed  in  the  same  manner  as  in  parenchymatous  goiter. 
When  both  glands  are  enlarged  and  general  symptoms  of 
athyrea  are  present,  potassium  iodid,  or  thyroid  extract  in 
small  doses  is  recommended. 

Vascular  Goiter.— Definition. — An  enlargement  of  one  or 
both  thyroid  glands,  characterized  by  dilatation  of  the 
bloodvessels  without  the  formation  of  new  glandular  tissue, 
and  the  absence  of  any  marked  general  symptoms.  This 
condition  is  not  to  be  confused  with  exophthalmic  goiter. 
It  is  the  result  of  a  local  dilatation  of  the  bloodvessels  supply- 
ing the  glands  and  may  originate  from  the  same  causes  as 
those  producing  congestion  and  inflammation  of  the  glands. 
The  exact  etiology  is  not  known,  but  has  been  observed  as  a 
sequel  to  distemper,  prolonged  estrual  periods,  and  sexual 
diseases. 

Symptoms.  —  One  or  both  glands  will  be  found  enlarged  and 
engorged  with  blood.  Distinct  pulsation  of  the  arteries 
and  even  the  glands  can  be  seen  at  a  distance.  In  some  cases 
rupture  of  some  of  the  vessels  results,  the  blood  accumulating 
in  the  adjacent  tissues,  producing  an  extensive  enlargement 
along  the  course  of  the  neck.  The  symptoms,  as  a  rule, 
subside  after  a  few  weeks  and  may  recur  at  more  or  less 
regular  intervals.  Many  cases  recover  spontaneously.  Very 
little  general  disturbance  is  present. 

Diagnosis.— The  dilatation  of  the  arteries  and  engorgement 
of  the  gland  will  easily  differentiate  it  from  all  forms  of  goiter, 
except  exophthalmic.  In  exophthalmic  goiter,  tachycardia, 


342  DISEASES  OF  THE   THYROID  GLANDS 

and  nervous  disturbances  present  should  make  the  clinical 
picture  complete  and  different  from  vascular  goiter. 

Prognosis.— Complete  recovery  is  possible  in  most  cases. 
In  the  milder  forms  it  often  disappears  without  any  treat- 
ment. 

Treatment.— An  examination  of  the  animal  should  be  made 
carefully  and  if  any  general  disturbance  is  observed  it  should 
be  treated.  Owing  to  the  increased  activity  of  the  gland 
locally,  iodin  preparations  are  contraindicated.  Small  doses 
of  tincture  of  opium  (0.2  to  0.4  daily)  can  be  tried. 

Should  the  glandular  activity  become  too  pronounced,  as 
indicated  by  hyperthyrea,  ligation  of  a  portion  of  the  blood 
supply  to  the  gland  would  be  indicated.  However,  in  the 
majority  of  cases  this  is  not  necessary  as  the  symptoms  will 
subside  in  the  course  of  a  few  weeks. 

Malignant  Goiter.— Definition.— An  enlargement  of  one  or 
both  thyroid  glands  due  to  a  malignant  neoplasm.  The 
malignant  growth  is  either  a  sarcoma  or  carcinoma.  The 
growth  tends  to  invade  the  adjacent  tissues  and  lymph  glands, 
or  even  to  the  extent  of  involving  secondarily  the  lymph 
glands  of  the  thoracic  cavity,  the  lungs,  and  other  organs 
and  tissues.  The  condition  may  become  generalized.  It  is 
found  mostly  in  old  animals. 

Symptoms.— The  malignant  growth  may  be  confined  to  one 
gland,  but  in  many  cases  occurs  in  both.  When  the  enlarge- 
ment once  begins,  its  development  is  quite  rapid,  and  is 
characterized  by  an  uneven,  irregular  form  of  the  gland,  the 
presence  of  acute  inflammatory  symptoms,  very  sensitive, 
and  in  some  cases  areas  of  degeneration  and  abscess  forma- 
tion are  found.  Within  a  short  time  general  symptoms 
are  prominent.  Emaciation  and  general  cachexia  develop 
rapidly.  The  rapidity  of  its  development  and  the  fact  that 
it  is  usually  an  old  animal  affected  would  assist  in  making  the 
diagnosis. 

Diagnosis.— This  is  made  by  careful  examination.  The 
characteristic  enlargement  and  condition  of  the  gland  with 
secondary  involvement  of  adjacent  lymph  glands,  together 
with  the  general  symptoms  of  emaciation  and  cachexia,  and 


GOITER— STRUM  A— BRONCHOCELE  343 

the  age  of  the  animal,  should  make  the  differentiation  from 
other  forms  of  goiter  comparatively  easy. 

Prognosis. —Unfavorable. 

Treatment.— But  little  can  be  expected  of  treatment.  In 
the  early  stages,  before  involvement  of  the  adjacent  tissues 
takes  place,  extirpation  of  the  gland  may  relieve  the  condition 
for  a  time  but  no  permanent  results  can  be  hoped  for. 

Exophthalmic  Goiter.— Basedow's  Disease.  Graves' s  Dis- 
ease.— Definition.— A  disease  characterized  by  exophthalmos, 
functional  disturbances  of  the  circulatory  system,  and  more 
or  less  enlargement  of  the  thyroid  gland.  This  disease  is 
not  of  frequent  occurrence  in  animals,  but  is  found  occa- 
sionally in  the  dog. 

Etiology.  —The  exact  etiological  factor  has  been  in  dispute, 
but  is  evidently  a  pure  neurosis  as  indicated  by  some  of  the 
more  recent  investigations  made.  It  has  also  been  claimed 
that  it  is  due  to  a  central  lesion  in  the  medulla  oblongata. 
A  certain  amount  of  evidence  has  been  produced  to  partially 
substantiate  this  claim.  The  fact  that  the  primary  result 
of  the  disease  is  a  hyperthyrea  would  indicate  that  it 
might  be  a  special  involvement  of  the  glands.  However,  this 
has  not  been  proved  and  the  best  evidence  seems  to  prove 
the  former  etiological  factor  the  most  likely. 

Pathology.— On  examination  the  thyroid  glands  show  en- 
largement, congestion,  the  production  of  newly  formed 
tubular  spaces  and  a  collection  of  mucinous  fluid.  They 
show  every  evidence  of  hyperactivity. 

Pathogenesis.— It  is  quite  important  from  every  standpoint 
to  note  that  this  form  of  goiter  is  a  primary  hyperthyrea 
while  most  forms  are  just  the  opposite  (athyrea).  The 
development  of  the  disease  is  the  result  of  the  increased 
secretion  of  the  thyroid  glands  leading  to  a  general  toxic 
condition.  The  iodothyroidin  content  of  the  secretion  is 
greatly  increased  which  no  doubt  accounts  for  the  intoxica- 
tion. 

From  an  experimental  standpoint  much  the  same  condition 
can  be  produced  in  animals  by  administering  large  and  con- 
tinued doses  of  thyroid  extract.  Further,  when  thyroid 
extract  or  iodin  is  administered  in  exophthalmic  goiter  the 
condition  becomes  rapidly  aggravated. 


344  DISEASES  OF  THE  THYROID  GLANDS 

Symptoms.— Both  the  acute  and  chronic  forms  have  been 
observed.  In  the  acute  form  the  disease  develops  very 
rapidly.  The  following  symptoms  are  most  prominent: 

(a)  Exophthalmos.—A.  prominence  of  the  eyes  which  may 
be  unilateral  or  bilateral.  This  symptom  is  readily  recog- 
nized by  the  protrusion  of  the  eyeballs,  and  the  prominence 
of  the  sclera  of  the  eye.  The  lids  do  not  cover  the  eye 
completely.  It  is  important  to  note  that  in  some  breeds  of 
dogs  the  eyes  are  very  prominent  and  this  should  not  be 
mistaken  for  exophthalmos.  The  normal  sight  is  retained 
in  most  cases.  In  severe  cases  it  is  possible  to  have  a  pan- 
ophthalmitis  which  wrould  destroy  the  sight  temporarily  or 
permanently.  Ulceration  of  the  cornea  is  common. 

(6)  Enlargement  of  the  Thyroid  Glands. — Some  enlarge- 
ment of  the  glands  is  present  in  practically  all  cases.  The 
common  expression  ".inward  goiter"  has  been  given  to  this 
condition  when  the  glands  are  not  much  enlarged  and  the 
other  symptoms  are  prominent.  The  enlargement  may  be 
general  or  only  one  lobe  affected. 

(c)  Tachycardia.— The  heart  action  is  rapid  and  the  pulse- 
rate  is  usually  so  much  increased  that  it  cannot  be  counted 
accurately.    The  action  of  the  heart  at  first  is  regular,  but 
during  the  later  stages  of  the  disease  becomes  very  irregular. 
The  throbbing  of  the  heart  is  often  so  intense  as  to  shake  the 
animal's  body.    Acute  dilatation  of  the  heart  with  dyspnea, 
cough,  etc.,  is  a  prominent  symptom  in  the  later  stages. 

Distention  of  the  arteries  and  pulsation  of  the  entire  gland 
is  easily  seen  from  a  distance.  On  palpation  a  distinct 
throbbing  can  be  felt.  The  gland  may  be  more  or  less  firm, 
or  soft  and  flabby,  depending  on  the  degree  of  involvement. 

(d)  Tremors. — Tremors  or  trembling  of  the  muscles  is 
often  observed.     General  symptoms  of  restlessness,  whining 
and  crying,  and  spasms  are  present  in  some  cases.     Emacia- 
tion  comes   on   rapidly,    and    general   exhaustion    is  very 
common. 

The  chronic  form  is  characterized  by  similar  symptoms 
but  milder  in  character  and  lasting  for  several  weeks  or 
months. 


GO  I TE  R—STR  UMA—BRONCHOCELE  345 

Diagnosis. — The  diagnosis  is  not  difficult  when  all  the 
symptoms  are  taken  into  consideration.  A  differential 
diagnosis  should  be  made  from  the  other  forms  of  goiter, 
but  aside  from  vascular  goiter  this  should  be  easy.  In 
vascular  goiter  the  general  symptoms  are  usually  absent. 

Prognosis.— Not  considered  favorable.  Some  cases  recover 
rapidly  under  proper  treatment. 

Treatment.— Owing  to  the  hyperthyrea  present,  iodin 
preparations  and  thyroid  extract  are  contraindicated.  The 
treatment  indicated  is  the  reduction  of  the  hyperactivity 
of  the  thyroid  glands,  and  regulating  the  heart  action.  The 
hyperactivity  of  the  glands  is  best  controlled  by  ligation  of  a 
portion  of  the  blood  supply  to  them  which  will  immediately 
stop  the  function  of  that  particular  part  and  reduce  the  total 
volume  of  secretion.  It  is  recommended  that  the  anterior 
arteries  be  ligated.  -This  should  be  done  under  strict  anti- 
septic precautions  and  morphin  anesthesia.  Immediate 
good  results  are  obtained  in  many  cases.  Extirpation  of  a 
portion  of  the  gland  is  often  done  in  the  human  subject  but 
is  not  so  practicable  in  animals.  The  heart  action  should 
be  controlled  by  small  doses  of  digitalis  fluidextract  (0.1  to 
0.2  twice  daily),  or  aconite  tincture  (0.1  to  0.2  two  or  three 
times  daily).  The  animal  should  be  kept  in  a  quiet  place. 
Other  conditions  arising  must  be  treated  accordingly. 


PART  VI. 
DISEASES  OF  METABOLISM. 


CHAPTER  I. 
DISEASES  OF  METABOLISM. 

DIABETES. 

Definition.— Diabetes  is  a  disease  ordinarily  characterized 
by  an  excessive  secretion  of  urine.  It  occurs  in  two  forms: 
(a)  Diabetes  insipidus;  (6)  diabetes  mellitus. 

Diabetes  Insipidus.— Definition.— A  chronic  disease  charac- 
terized by  the  passage  of  a  large  volume  of  urine  of  a  low 
specific  gravity  and  containing  no  albumin  or  sugar.  There 
should  be  a  distinction  made  between  diabetes  insipidus  and 
polyuria.  The  latter  is  a  symptom  of  some  other  disease. 
In  polyuria,  often  confused  with  diabetes  insipidus,  the 
volume  of  urine  passed  is  not  constant.  The  disease  is 
evidently  a  functional  disturbance  of  the  kidneys  in  which 
large  quantities  of  water  are  voided  and  equal  amounts  taken 
into  the  system.  The  solid  content  of  the  urine  is  naturally 
reduced. 

Occurrence.  — Diabetes  insipidus  is  not  observed  very  often, 
but  perhaps  the  larger  number  of  cases  is  folmd  in  dogs. 
Polyuria  is  frequently  seen  in  rabbits  from  improper  feeding. 
Certain  foods  tend  to  produce  it,  which,  if  continued,  may 
result  in  a  chronic  condition  resembling  diabetes  insipidus. 
There  is  no  doubt  but  that  it  is  often  not  diagnosed. 

Etiology.— Several  things  have  been  recorded  as  having  to 
do  with  the  cause  of  diabetes  insipidus:  (a)  Observed  dur- 


348  DISEASES  OF  METABOLISM 

ing  the  convalescent  stage  of  acute  diseases  (distemper).  (&) 
Accompanying  diseases  of  the  nervous  system,  such  as 
tumors  of  the  brain,  lesions  of  the  medulla,  cerebral  hemor- 
rhage, inflammation  of  the  membranes  of  the  brain  or  spinal 
cord,  (c)  Subjection  to  cold;  drinking  large  quantities  of 
cold  water  have  been  thought  to  cause  the  disease,  (d) 
Trauma  of  the  liver;  vertebral  column,  (e)  The  administra- 
tion of  diuretics  either  when  given  in  large  doses  or  con- 
tinued over  a  long  period  of  time  in  small  doses  will  produce 
it.  (/)  There  is  a  possibility  that  the  disease  is  of  infectious 
origin;  however,  this  has  never  been  proved. 

The  production  of  diabetes  insipidus  is  no  doubt  due  to 
a  vasomotor  disturbance  of  the  renal  vessels  resulting  in  a 
great  increase  in  the  secretion  of  urine.  The  above  men- 
tioned conditions  lead  to  this  disturbance  through  direct 
irritation,  or  to  functional  irritation  of  the  center  in  the 
medulla,  which  brings  about  a  constant  state  of  renal  con- 
gestion. 

Pathology.— The  necropsy  findings  are  unimportant  in  the 
majority  of  cases.  Quite  often  very  slight  or  no  changes  in 
the  tissues  are  found.  In  some  cases  the  kidneys  are  enlarged 
and  hyperemic.  Dilation  of  the  ureters  and  pelvis  of  the 
kidneys  is  occasionally  seen.  Certain  changes  will  also 
be  found  in  the  nervous  system,  liver  and  lungs.  The 
musculature  is  pale  and  anemic  in  advanced  cases. 

Symptoms.— The  disease  may  come  on  suddenly  resulting 
from  irritation  to  the  nervous  system  or  kidneys,  or  it  may 
be  gradual  in  its  development.  In  rabbits  it  may  develop 
suddenly  after  feeding  mouldy  food,  etc.  Many  cases  are 
not  observed  until  the  symptoms  of  anemia  and  general 
cachexia  are  present.  Two  very  prominent  symptoms  are: 
(a)  Copious  secretion  of  urine;  (6)  intense  thirst. 

(a)  A  large  quantity  of  urine  is  passed  each  day;  in  dogs 
as  much  as  two  to  four  liters  in  twenty-four  hours,  and  in 
rabbits  one-fourth  the  quantity.  The  urine  has  a  low 
specific  gravity  (1.001  to  1.003),  is  colorless,  almost  odorless, 
and  voided  without  any  difficulty  except  when  the  condition 
is  accompanied  by  a  catarrhal  inflammation  of  the  mucous 
membrane  of  the  urethra  or  bladder.  The  urine  contains 


DIABETES  349 

neither  albumin  nor  sugar.  Normal  solids  are  very  much 
reduced  in  quantity. 

(6)  The  animal  will  show  intense  thirst;  large  quantities 
of  water  are  consumed  each  day,  in  dogs  as  much  as  four  to 
ten  liters.  Often  animals  will  show  a  vitiated  thirst  and 
will  drink  contaminated  water  or  even  urine.  The  appetite 
is  usually  normal  during  the  first  stages,  but  gradually 
diminishes  and  becomes  variable.  During  the  later  stages 
the  appetite  may  be  lost  entirely,  the  animal  becoming 
emaciated,  and  various  complications  develop.  The  tem- 
perature remains  normal  until  the  very  latest  stages  when 
it  may  be  subnormal. 

Course.— When  polyuria  results  from  the  food  it  may 
disappear  in  a  short  time  following  the  change  in  food.  This 
has  been  observed  particularly  in  rabbits.  In  cases  of  real 
diabetes  insipidus  the  course  is  chronic,  the  disease  lasting 
one  or  two  years. 

Diagnosis.— A  differential  diagnosis  must  be  made  between 
diabetes  insipidus,  polyuria  and  diabetes  mellitus.  Polyuria 
is  distinguished  from  diabetes  insipidus  by  the  symptoms 
disappearing  when  the  food  is  changed.  The  symptoms  of 
polyuria  are  also  more  variable.  Diabetes  mellitus  is  dis- 
tinguished by  the  increased  specific  gravity  of  the  urine  and 
the  sugar  content. 

Prognosis.— ^Yhile  in  polyuria  the  prognosis  is  usually 
favorable,  in  real  diabetes  insipidus  it  is  bad,  the  disease 
terminating  fatally  after  a  prolonged  course. 

Treatment.— An  investigation  of  the  food  should  be  made, 
and  if  found  of  poor  quality,  containing  moulds  or  other 
objectionable  substances,  it  should  be  discontinued  and  other 
foods  substituted.  Regulation  of  the  diet  is  an  important 
factor  during  the  early  stages  of  the  disease.  Limiting  the 
water  supply  does  not  have  any  appreciable  effect  on  true 
diabetes  insipidus,  but  if  it  is  a  simple  polyuria  it  would  be 
well  to  restrict  the  patient  to  a  small  amount  of  water. 

Medical  treatment  has  not  been  satisfactory.  Small  doses 
of  valerianate  of  zinc  (0.2  to  0.4)  daily,  may  be  tried;  or 
vasoconstrictors  used,  such  as  fluidextract  of  hydrastis,  or 
fluidextract  of  ergot.  Stomachics  and  general  tonics  may  be 


350  DISEASES  OF  METABOLISM 

of  some  value,  tincture  nux  vomica  (0.3  to  0.6),  once  or 
twice  daily. 

Diabetes  Mellitus.— Definition.— Diabetes  mellitus  is  a 
chronic,  nutritive  disorder  in  which  grape-sugar  accumulates 
in  the  blood  and  is  excreted  in  the  urine.  The  condition  may 
be  permanent  or  occur  periodically.  It  is  generally  con- 
sidered that  in  order  for  a  case  to  be  true  diabetes  mellitus, 
the  sugar  eliminated  must  be  grape-sugar,  and  it  must  extend 
over  a  rather  long  period  of  time. 

Occurrence.— The  disease  is  not  very  common  in  animals. 
A  few  cases  have  been  found  in  dogs.  The  cat  and  rabbit 
are  very  seldom  affected. 

Etiology. — The  exact  etiology  of  diabetes  mellitus  is  not 
known.  It  is  quite  evident  that  several  factors  may  have  to 
do  with  the  production  of  the  disease.  Nervous  diseases, 
especially  those  of  the  central  nervous  system,  and  diseases 
of  the  liver  and  pancreas  probably  produce  the  larger  number 
of  cases.  The  pathogenesis  of  diabetes  mellitus  is  not  quite 
clear,  but  the  condition  may  be  brought  about  by  a  disturb- 
ance of  the  liver  or  pancreas,  in  which  the  grape-sugar  taken 
into  the  body  is  not  converted  into  glycogen  but  taken  up  as 
grape-sugar  by  the  circulation  and  eliminated  in  this  form. 

Pathology.— Many  cases  present  no  anatomical  changes. 
There  may  be  hemorrhages  in  the  nervous  system,  tumor 
formations,  etc.  Very  often  fatty  degeneration  of  the  liver 
is  present.  The  pancreas  may  be  enlarged  by  connective 
tissue  proliferation  and  an  atrophy  of  the  glandular  substance. 
The  other  structures  show  emaciation  and  evidences  of 
cachexia  due  no  doubt  to  the  chronicity  of  the  disease. 

Symptoms.— Until  the  patient  shows  emaciation,  notwith- 
standing good  appetite,  the  disease  is  usually  not  recognized. 
The  general  symptoms  are:  The  animal  fatigues  easily, 
becomes  dull  and  listless  and  does  not  move  about  in  a  normal 
way,  shows  increased  thirst  and  appetite.  The  mucous 
membrane  of  the  mouth  becomes  dry,  and  gingivitis  is  often 
present.  The  most  characteristic  symptoms  are  found  in 
connection  with  the  urinary  organs.  The  urine  is  increased 
in  amount,  sometimes  double  the  normal  quantities  voided, 
is  pale,  colorless,  of  a  sweetish  odor  (aceton)  and  acid  in 


DIABETES  351 

reaction.  The  specific  gravity  is  increased  (1040  to  1060). 
An  examination  of  the  urine  should  be  made  to  determine  the 
sugar  content.  From  3  to  5  per  cent,  of  sugar  has  been 
found.  The  amount  of  sugar  content  will  depend  to  quite 
an  extent  on  the  kind  of  food  given  the  patient.  The 
feeding  of  carbohydrates  materially  increases  the  per  cent, 
while  nitrogenous  foodstuffs  diminish  it.  (For  testing  for 
sugar  in  the  urine,  see  Diseases  of  the  Kidneys.) 

As  the  disease  progresses  certain  other  symptoms  are 
uniformly  present.  Opacity  of  one  or  both  cornea  (keratitis) , 
or  of  the  lens  (cataract)  is  often  found,  gradually  producing 
blindness.  Other  portions  of  the  eye  may  also  be  affected, 
llceration  of  the  cornea  has  been  observed.  Secondary 
involvement  of  the  respiratory  organs  takes  place  in  the  form 
of  a  catarrhal  inflammation  of  the  larynx,  trachea,  bronchial 
tubes  and  lungs.  Pneumonia  and  gangrene  of  the  lungs  may 
develop.  Cardiac  weakness  is  noted  during  the  last  stages. 
Other  symptoms,  such  as  vomiting,  diarrhea  and  constipation, 
may  be  seen.  Ulceration  of  the  skin,  falling  out  of  the  hair, 
found  in  some  cases,  indicate  the  general  disturbance  in 
metabolism.  During  the  last  stages  the  patient  becomes  very 
weak,  emaciated,  cachectic,  and  dies  from  exhaustion. 

Course. — The  disease  is  characterized  by  its  chronicity  and 
may  last  from  several  months  to  two  years.  Sugar  is  some- 
times present  in  the  urine  for  a  long  time  before  the  disease 
is  recognized. 

Diagnosis.— This  disease  should  be  differentiated  from 
diabetes  insipidus.  In  the  former  the  presence  of  sugar  in 
the  urine,  the  gradual  emaciation  and  the  retention  of  the 
appetite  would  be  sufficient  to  make  a  positive  diagnosis. 

Prognosis.— Is  always  unfavorable.  The  disease  is  a 
progressive  one,  in  which  complications  follow  each  other 
making  the  condition  hopeless. 

Treatment. — Very  little  can  be  accomplished  except  by 
regulation  of  the  diet  and  limiting  the  carbohydrates  fed. 
Dogs  should  be  fed  on  a  diet  rich  in  fats  and  proteids  (eggs, 
fat  meat,  or  oat  meal  with  fat  meat) .  Large  doses  of  sodium 
bicarbonate  should  be  given  (1.5  to  2.5)  daily  to  reduce  the 
acidosis  which  is  apt  to  develop.  The  amount  may  be 


352  DISEASES  OF  METABOLISM 

increased  if  necessary.  Other  alkaline  agents,  such  as 
Carlsbad  salts  and  ammonium  carbonate,  may  also  be 
administered.  Tincture  of  opium  in  large  doses  (0.6  to  1.0) 
once  or  twice" -daily  is  highly  recommended  as  it  tends  to 
reduce  the  amount  of  sugar.  The  treatment  at  best  can  only 
bring  about  temporary  relief,  and  no  permanent  results  can 
be  hoped  for. 

It  is  important  that  the  patient  be  kept  quiet  and  its 
general  strength  maintained. 

OBESITY. 

Definition.— An  excessive  fat  accumulation  in  the  body 
which  may  be  general  throughout  the  entire  organism,  or 
confined  to  certain  localized  areas,  such  as  under  the  skin. 
The  condition  is  very  commonly  observed  in  small  animals, 
particularly  in  dogs.  Certain  breeds,  especially  the  smaller, 
are  most  subject.  Castrated  animals,  especially  if  castrated 
after  maturity,  tend  to  become  obese. 

Etiology.— One  of  the  chief  factors  in  the  production  of 
obesity  is  the  taking  in  of  larger  quantities  of  food  elements 
than  are  utilized  in  the  body.  Pet  animals  which  are  fed 
highly  nutritious  foods  (candies,  cakes,  etc.)  and  are  not 
given  sufficient  exercise  become  over-fat.  It  often  happens 
that  an  animal  will  accumulate  fat  rapidly  when  only  the 
normal  amount  of  food  is  allowed.  This  occurs  in  most  cases 
from  insufficient  exercise,  the  elements  taken  in  not  being 
utilized.  The  feeding  of  large  quantities  of  carbohydrates, 
or  restricting  the  diet  to  substances  containing  a  large 
proportion  of  such  elements  will  bring  it  about.  The  tem- 
perament of  animals  no  doubt  has  also  some  influence. 
Animals  having  a  phlegmatic  temperament  tend  to  become 
obese  through  insufficient  activity  and  exercise.  Castration 
of  animals  changes  their  disposition,  tends  to  make  them 
phlegmatic  and  lazy,  and  therefore  fit  subjects  for  the 
development  of  this  condition.  Should  animals  be  castrated 
before  maturity  this  tendency  for  obesity  is  not  so  noticeable. 

Anemia  by  reducing  muscular  energy  may  cause  obesity, 
providing  no  organic  lesion  is  present  and  the  proper  amount 


OBESITY  353 

of  food  is  allowed.  The  majority  of  cases  can  be  ascribed 
to  hyperalimentation  and  lack  of  exercise,  rather  than  any 
constitutional  disturbance  of  metabolism.  Through  the 
disturbance  of  glandular  secretions  (thyroid)  and  its  regula- 
tion by  certain  organs  (adrenals,  pancreas,  etc.)  oxidation 
is  diminished  and  constitutional  obesity  may  develop. 

Pathology.— No  anatomical  changes  are  noted  except  a 
general  accumulation  of  fat  under  the  skin,  in  the  muscles, 
liver,  around  the  heart  and  other  organs.  The  changes  in 
appearance  of  the  organs  and  tissue  are  due  to  the  fatty 
deposits. 

Symptoms.— The  condition  is  characterized  by  the  rapid 
increase  in  weight,  the  change  in  contour  of  the  body,  and 
in  the  disposition  of  the  animal.  The  most  common  loca- 
tions of  observable  fatty  deposits  are  in  the  panniculus 
adiposus,  neck,  shoulders  and  abdomen.  Palpation  of  the 
parts  will  reveal  the  condition.  The  animal  shows  lassitude, 
fatigues  easily,  and  often  shows  dyspnea  on  exercise.  This 
is  no  doubt  the  result  of  impeded  action  of  the  organs 
from  the  fatty  accumulations.  Later,  during  the  progress 
of  the  condition,  disturbances  of  other  organs  and  functions 
will  develop.  Digestive  disturbances  are  often  quite  pro- 
nounced and  the  heart  action  may  be  interfered  with.  The 
mucous  membranes  are  pale,  showing  anemia. 

Course.  —The  course  is  chronic.  Mild  degrees  of  obesity 
do  not  interfere  particularly  with  the  animals'  health  or  use- 
fulness. 

Prognosis.— Depends  a  great  deal  upon  the  extent  of  the 
condition.  If  the  diet  can  be  regulated  and  restricted,  the 
prognosis  is  quite  favorable.  In  pet  animals,  however,  it  is 
very  difficult  to  restrict  the  diet  as  the  owner  will  invariably 
break  the  rules  laid  down  in  this  regard. 

Treatment.— Reduction  in  the  amount  of  food,  system- 
atic and  forced  exercise  are  important.  At  first  the  reduc- 
tion in  food  should  be  slight  but  continuous  until  only  a 
sufficient  amount  is  allowed  to  maintain  the  strength  of  the 
patient.  The  composition  of  the  foodstuffs  given  is  also 
important.  Limit  the  amount  of  carbohydrates  and  fats 
and  allow  a  greater  proportion  of  nitrogenous  foods.  A 
23 


354  DISEASES  OF  METABOLISM 

reduction  in  the  amount  of  drinking  water  should  be 
attempted. 

The  medical  treatment  consists  in  administering  small  doses 
of  magnesium  sulphate  (5.0  to  12.0)  daily,  or  Carlsbad  salts 
(4.0  to  10.0)  once  or  twice  daily.  Care  should  be  taken  to 
avoid  a  too  severe  laxative  action  over  a  long  period  of  time. 

Thyroid  extract  is  of  value  in  increasing  the  oxidation  of 
fats.  Thyroidinum  depuratum  (0.2  to  0.75),  or  iodo- 
thyrin  (0.1  to  0.2)  administered  once  daily  has  given 
the  best  results.  The  proteid  food  elements  should  be 
increased  slightly  when  these  medicinal  agents  are  adminis- 
tered. Complications,  should  they  arise,  are  given  appropri- 
ate treatment. 

GOUT.     PODAGRA.     ARTHRITIS  URICA. 

Definition.— A  disturbance  of  nutrition  with  an  excess  of 
uric  acid  in  the  blood.  It  is  characterized  clinically  by 
attacks  of  acute  arthritis,  a  gradual  accumulation  of  sodium 
biurate  in  and  adjacent  to  the  articulations,  and  with  the 
development  of  irregular  constitutional  symptoms.  The  con- 
dition may  involve  the  internal  organs,  or  both  the  organs 
and  the  articulations. 

Occurrence.— Old  dogs  are  most  commonly  affected. 
Birds,  especially  chickens,  pheasants  and  pigeons,  are  also 
common  sufferers.  Experience  has  shown  that  it  is  far  more 
common  in  fowls  than  in  any  of  the  other  small  animals. 

Etiology.— The  real  factors  in  the  production  of  gout  are 
not  definitely  known.  The  following,  probably  predisposing 
causes,  are  the  most  important:  (a)  The  diet  evidently 
plays  an  important  role  in  the  production  of  the  disease. 
Foods  rich  in  albumin,  particularly  nucleoproteids,  seem  to 
favor  the  development  of  the  condition.  Chickens  and  other 
birds  wrhen  fed  on  meat,  and  meat  scraps,  are  often  found  with 
the  disease.  Feeding  offal  from  slaughter  houses  has  the 
same  effect.  (6)  Certain  chemical  substances,  such  as  lead, 
chromic  acid,  corrosive  sublimate,  carbolic  acid,  acetone, 
etc.,  seem  to  have  some  effect  in  bringing  on  the  disease. 
(c)  It  may  be  due  to  the  change  in  the  metabolic  processes. 


GOUT— PODAGRA— ARTHRITIS   URICA  355 

(d)  Fungi  on  grains  and  grasses  haye  been  found  to  be  the 
cause  in  fowls,  (e)  Diseases  of  the  kidneys  and  ureters,  in 
which  there  is  an  interference  in  the  elimination  of  the  uric 
acid  compounds,  have  proved  to  be  important  factors  in  its 
production.  (/)  Lack  of  exercise,  confinement  of  the  animals 
or  birds,  together  with  the  feeding  of  highly  nitrogenous 
foods  are  no  doubt  the  cause  of  quite  a  number  of  cases  of 
gout.  Older  dogs,  and  the  larger  breeds  of  chickens  are  most 
commonly  affected. 

Pathogenesis.— The  development  of  gout  is  probably  due 
to  an  increase  in  the  production  of  uric  acid,  and  an  inhibition 
in  the  elimination  of  urates,  which  allows  its  accumulation 
in  the  blood,  and  in  certain  cases  to  be  deposited  in  connec- 
tion with  the  tissues.  Other  theories  have  been  advanced 
for  the  development  of  the  disease  and  have  supporters.  It 
is  possible  also  to  have  the  disease  develop  in  cases  when 
there  is  no  increase  in  the  formation  of  uric  acid,  but  other 
diseases  being  present  to  interfere  with  the -elimination  of  the 
uric  acid  compounds. 

Pathology.— The  characteristic  lesions  found  in  articular 
gout  are  enlargement  of  the  joints  of  the  toes,  or  wings,  and 
a  chalky-like  deposit  found  in  the  joint  proper  or  in  the 
adjacent  tissue.  Examination  of  the  bone-marrow,  and  the 
ligaments  and  tendons  around  the  joint  will  often  reveal 
the  same  condition.  Several  joints  may  be  found  affected. 
In  visceral  gout,  the  serous  membranes  of  the  cavities,  the 
pericardium,  air  sacs,  and  the  liver  are  covered  with  small 
nodules  containing  the  same  white  chalky  material.  The 
kidneys  contain  small  white  foci,  and  the  ureters  are  often 
found  filled  with  a  white,  pasty  mass.  Examination  of  this 
material  under  the  microscope  will  reveal  the  crystals  of 
sodium  biurate. 

Symptoms.— The  first  indications  of  the  condition  are 
usually  enlargement  of  one  or  more  joints,  difficulty  in 
walking  about,  and  lameness.  The  joints  most  commonly 
enlarged  are  the  wing  joints  (birds),  and  the  metatarsal  and 
phalangeal  joints  in  dogs  and  birds.  The  animal  will  stand 
quietly  and  refuse  to  move,  but  when  forced  to  do  so  shows 
considerable  pain  and  lameness.  Fowls  often  assume  a 


356  DISEASES  OF  METABOLISM 

crouching  position  standing  on  one  limb  or  shifting  from  one 
leg  to  the  other.  Birds  will  walk  or  flap  their  wings  with  a 
minimum  use  of  muscles  owing  to  the  pain  induced.  Exami- 
nation of  the  wings  will  show  enlargement  of  one  or  more 
joints.  At  first  the  swellings  are  soft  and  sensitive,  but 
later  become  more  defined,  firmer  and  not  so  painful.  The 
size  of  the  nodules  will  vary  in  different  birds  but  is  usually 
from  that  of  a  pea  to  a  hickory  nut.  Considerable  deformity 
of  the  joints  of  the  wings  and  limbs  may  be  present.  The 
toes  are  often  spread  apart  from  the  enlargement.  In  some 
cases  the  joints  become  anchylosed,  while  in  others  degenera- 
tion takes  place  with  necrosis  and  a  discharge  of  a  whitish- 
yellow  soft  mass.  In  the  latter  case  there  will  be  an  ulcera- 
tive  process  left  which  often  exposes  the  joint.  Small 
nodules  are  found  in  other  locations  in  the  skin,  muscles, 
and  tendons.  The  general  symptoms  of  rough  plumage, 
pendent  wings,  paleness  of  the  comb  and  wattles,  and  general 
emaciation  develop  gradually.  The  bird  will  frequently  die 
from  exhaustion. 

Dogs  show  enlargement  of  the  joints  of  the  toes,  meta- 
tarsus ribs,  etc.  Lameness  and  stiffness  are  quite  prominent 
symptoms.  A  careful  examination  should  be  made  in  all 
cases.  Internal  or  visceral  gout  will  not  be  recognized  except 
when  accompanied  by  enlargement  of  the  joints. 

Course.— The  disease  is  practically  always  chronic.  A  few 
cases  have  been  recorded  of  the  acute  form.  The  disease 
develops  irregularly  from  one  joint  to  another  and  therefore 
runs  a  protracted  course. 

Diagnosis.— The  characteristic  symptoms  of  enlargement 
of  several  joints,  microscopic  examination  of  the  contents  of 
the  nodules,  and  chemical  examination  will  make  the  diag- 
nosis positive. 

Treatment.— Dietetic.— Foods  rich  in  nitrogenous  sub- 
stances should  be  withheld.  If  necessary  reduce  the  total 
feed  ration  for  a  few  days  to  a  week. 

Medical.— Alkaline  agents,  such  as  sodium  bicarbonate 
should  be  used  freely  in  the  drinking  water  of  the  fowls. 
Give  dogs  1.5  to  2.0  two  or  three  times  daily.  The  alkaline 
preparations  will  assist  in  the  elimination  of  the  deposited 


FEATHER  EATING— FEATHER  PULLING  IN  BIRDS    357 

urates.  Piperazin  is  highly  recommended  to  prevent  the 
development  of  the  urates  in  the  tissues  (chickens,  0.2  to 
1.0;  pigeons,  0.1  to  0.4;  dogs,  0.5  to  1.0).  Small  doses  are 
to  be  given  three  times  daily  and  continued  for  several 
days.  Internal  administration  of  sodium  salicylate  has  been 
tried  with  fairly  good  results.  Local  applications  of  menthol, 
or  salicylic  acid  should  be  used.  I^ffect  a  solution  and  apply 
to  affected  joint  on  absorbent  cotton.  When  the  nodules 
become  large  they  should  be  opened,  curetted  and  an  anti- 
septic pack  applied. 

FEATHER  EATING.     FEATHER  PULLING  IN  BIRDS. 

A  condition  observed  very  commonly  in  caged  birds, 
canaries  and  parrots,  but  also  in  chickens,  turkeys  and 
pigeons. 

Etiology .  — (a)  It  may  be  the  result  of  improper  food. 
Feeding  the  same  materials  for  a  long  period,  or  foods  in  which 
there  is  a  deficiency  of  certain  nutritive  elements  is  a  cause. 
Confinement  of  birds  in  close  quarters  predispose  to  it, 
partly  through  lack  of  exercise,  and  partly  to  a  narrowing 
of  the  feed  ration.  (6)  It  is  often  considered  a  vice  or  habit. 
Fighting  or  picking  at  each  other  starts  the  vice,  (c)  Results 
from  skin  diseases,  especially  from  parasitic  conditions  (lice, 
fleas,  mange  mites).  The  irritation  from  the  parasite  leads 
to  picking  at  the  skin  and  feathers.  Feathers  will  drop  out 
as  a  result  of  certain  diseased  conditions. 

Symptoms.— Birds  are  observed  to  be  pulling  out  their 
own  feathers  or  of  those  confined  with  them.  Bald  spots  will 
be  noticed  on  different  parts  of  the  body.  Often  large  areas 
are  denuded.  Careful  observation  of  a  flock  reveals  the 
situation.  In  skin  diseases  the  feathers  fall  out  which  can 
easily  be  distinguished  from  feather  pulling.  The  skin 
lesions  will  assist  in  making  the  differentiation. 

Treatment.  — Birds  confined,  especially  chickens,  turkeys 
and  pigeons,  should  be  given  freer  range.  Complete  change 
of  food  will  have  an  important  bearing  on  overcoming  the 
condition.  Feed  plenty  of  oyster  shell,  bone  meal,  meat 
scrap,  dried  blood,  etc.,  with  green  foods  to  supply  the 


358  DISEASES  OF  METABOLISM 

elements  lacking.  Parrots  and  canaries  are  difficult  to  relieve 
from  the  habit.  Change  in  the  food,  with  plenty  of  green 
materials  will  often  help.  Examine  them  carefully  to  be 
sure  they  are  free  from  lice,  or  other  parasites.  Bitter  solu- 
tions applied  to  the  feathers  may  stop  it.  Feather  eating 
is  difficult  to  control,  but  change  of  food  as  described  above, 
and  the  administration  of  small  doses  of  apomorphin  hydro- 
chlorid  (0.0005-0.001)  have  proved  to  be  of  value  in  a  number 
of  cases. 


CHAPTER  II. 

DISEASES  OF  METABOLISM  AFFECTING 
PRIMARILY  THE  BONES. 

RACHITIS.     RICKETS. 

Definition.— A  disease  of  young  animals,  characterized  by 
impaired  nutrition  of  the  entire  body  and  disturbances  and 
changes  in  the  growth  of  the  bones  leading  to  marked 
deformity. 

Occurrence.— The  disease  is  rather  widespread,  appearing 
in  nearly  all  countries.  Animals  in  some  countries  are  very 
commonly  affected,  while  in  others  the  disease  is  not  so 
prevalent.  Young  animals,  as  a  rule,  become  affected  during 
the  first  few  weeks  of  life,  or  at  about  weaning  time.  The 
condition  is  observed  more  commonly  in  dogs  than  in  any 
of  the  other  small  animals.  Cats  and  rabbits  are  not  very 
often  affected.  Fowls  occasionally  suffer  from  the  disease, 
especially  chickens  and  pigeons.  It  is  commoner  in  the 
larger  breeds  of  dogs  and  fowls,  perhaps  due  to  their  more 
rapid  growth  during  early  life. 

Etiology.— Various  factors  have  been  given  as  the  cause  of 
rachitis :  (a)  Due  to  a  deficiency  of  lime  salts  in  the  organism. 
This  is  no  doubt  one  of  the  most  important  causes  of  the 
condition,  as  it  develops  most  frequently  in  the  breeds  that 
grow  rapidly,  and  at  a  time  in  the  animal's  life  when  there  is 
apt  to  be  a  deficiency  in  the  amount  of  lime  salts  ingested. 
Clinical  and  experimental  evidence  tend  to  prove  the  accuracy 
of  this  statement.  (6)  Improper  assimilation  of  lime  salts 
due  to  a  lack  in  the  acid  content  of  the  gastric  juice  preventing 
the  lime  salts  from  being  dissolved  and  consequently  not 
absorbed.  Foods  rich  in  potassium  salts  reduce  the  hydro- 
chloric acid  content  in  the  stomach  leading  to  an  insufficient 


360  DISEASES  OF  METABOLISM 

solution  or  absorption  of  the  lime  salts,  (c)  Digestive 
disturbances  (gastric  and  intestinal  catarrh)  reduce  the 
amount  of  lime  salts  absorbed  by  increasing  the  normal 
elimination  of  calcium  compounds  from  the  intestines.  In 
young  animals  this  condition  often  occurs  at  the  time  of 
weaning  when  the  character  of  the  food  is  suddenly  changed. 
(d)  Inflammatory  conditions  of  the  bones  in  which  the  blood- 
vessels are  enlarged  and  the  circulation  increased  preventing 
the  depositing  of  the  lime  salts  in  the  new  bone  tissue.  This 
process  keeps  the  lime  salts  in  solution  instead  of  being 
deposited  in  their  normal  manner,  (e)  The  possibility  of 
infection  having  to  do  with  the  production  of  rachitis  has 
been  considered,  but  not  proved.  Various  toxic  agents 
(poisons)  wrill  bring  about  a  disturbance  in  the  function  of 
the  normal  metabolic  processes  in  the  body  and  possibly 
bring  on  the  condition  or  predispose  to  it.  (/)  Absence  of 
sunlight,  dark,  damp  and  unsanitary  cellars  are  no  doubt 
predisposing  causes.  Heredity  has  been  mentioned  also  as 
having  some  influence  in  the  development  of  the  disease. 
It  is  quite  evident  that  the  exact  etiological  factor  in  the 
production  of  rachitis  has  not  yet  been  determined. 

Pathology.— The  deformity  occurring  in  rachitis  is  found 
mainly  in  connection  with  the  long  bones.  The  diaphyses 
of  the  bones  are.  shortened,  softened,  become  curved.  The 
epiphyses  are  thickened,  more  or  less  spongy,  and  much 
enlarged.  The  bones  are  much  softer  than  normal  and  have 
the  consistency  of  decalcified  bone.  They  can  be  cut  easily 
with  a  knife.  The  periosteum  is  thickened,  reddened  and 
when  removed  from  the  bones  may  include  some  of  the  bone 
substance.  In  many  cases  the  interior  of  the  bones  is  soft 
and  the  canal  abnormally  large.  The  short  bones  are  found 
spongy  and  easily  separated.  Marked  deformity  occurs  in 
the  skull  bones  which  are  often  separated.  The  patient  in 
general  will  show  evidences  of  malnutrition. 

Symptoms.— During  the  early  stages  of  the  disease,  before 
deformity  of  the  bones  is  present,  there  are  gastric  and 
intestinal  disturbances  (catarrh),  and  evidences  of  mal- 
nutrition. Weakness,  loss  of  appetite,  diarrhea  and  tendency 


RA  CHI  TI  S—RfCKE  TX  36 1 

for  bloating  are  observed  in  the  early  stages.  Very  often 
the  disease  is  not  noted  until  the  change  in  the  form  of  the 
bones  begins.  Deformity  appears  in  various  places.  The 
bones  of  the  head  and  face  show  a  bulging  which  gives  the 
animal  a  peculiar  appearance.  The  limb  bones  show  curva- 
ture and  enlargement  at  the  joints.  Palpation  along  the 
ribs  at  the  attachment  of  the  bones  to  the  cartilage  will  reveal 
small,  rounded  enlargements.  Twisting  and  curvature  of 
the  spine  are  quite  commonly  observed.  The  teeth  become 
loose  and  displaced,  the  gums  soft  and  spongy  and  bleed 
easily.  Deformity  of  other  bones  may  be  present.  General 
emaciation,  weakness  and  irregular  development  of  the 
bones,  writh  marked  gastric  and  intestinal  disturbances  are 
prominent  symptoms. 

Course. — The  course  of  rachitis  is  nearly  always  chronic, 
lasting  for  several  months.  Occasionally  the  condition  runs 
an  acute  course  when  complications  are  present. 

Prognosis.— When  the  disease  is  observed  early  and  treated, 
the  prognosis  is  rather  favorable.  After  there  is  marked 
deformity  and  evidences  of  emaciation  and  malnutrition 
very  little  can  be  hoped  for. 

Treatment. — The  first  consideration  in  the  treatment  should 
be  the  diet.  Dogs  should  be  allowed  plenty  of  meat  with 
the  addition  of  ground  bone.  In  birds  meat  scraps  and  ground 
bone  seem  to  produce  the  best  results.  Gastric  and  intestinal 
catarrh  should  be  treated,  if  present,  by  alkalies  and  mild 
laxatives.  The  lime  deficiency  must  be  relieved  by  the 
administration  of  lime  salts.  Syrup  of  calcium  lactophos- 
phate  has  been  very  satisfactory  for  this  purpose  (dogs,  8.0- 
12.0;  chickens,  1.0-2.0).  This  should  be  given  twice  daily 
and  continued  for  a  few  weeks.  Chalk  (calcium  carbonate), 
or  calcium  phosphate  is  also  to  be  recommended  in  doses 
of  1.0  to  8.0  daily.  In  some  cases  there  will  also  be  a 
deficiency  of  phosphorus  which  can  be  replaced  with  calcium 
phosphate.  Phosphorus  in  a  bland  oil  (dogs,  0.001-0.002  in 
10.0  oil;  birds,  0.005-0.001  in  2.0  oil)  is  also  recommended. 
Small  doses  of  hydrochloric  acid,  well  diluted,  will  assist  in 
the  solution  and  assimilation  of  lime. 


362  DISEASES  OF  METABOLISM 

In  dogs,  when  the  limb  bones  become  soft  and  deformed, 
splints  and  bandages  are  useful  to  act  as  a  support  which 
reduces  the  deformity  to  a  minimum. 

OSTEOMALACIA.     BRITTLENESS  OF  BONES. 

Osteomalacia  occurs  so  rarely  in  small  animals  that  the 
reader  is  referred  to  other  works  for  the  discussion  of  it. 


PART  VII. 
DISEASES  OF  THE  ORGANS  OF  LOCOMOTION. 


CHAPTER   I. 

ARTICULAR  RHEUMATISM.    POLYARTHRITIS 
RHEUMATICA. 

Definition.— Articular  rheumatism  is  evidently  an  infectious 
febrile  disease  in  which  several  joints  are  affected.  It  is  a 
serous  or  serofibrinous  inflammation  of  the  joints.  It  may 
suddenly  shift  from  one  joint  to  another. 

Etiology.— The  actual  cause  of  the  disease  has  never  been 
definitely  proved,  but  all  indications  point  to  infection. 
Several  factors  no  doubt  have  considerable  influence  in 
bringing  on  the  attacks,  such  as  (a)  subjection  to  cold  and 
chilling  the  surface  of  the  body;  (6)  keeping  animals  in  cold, 
damp  cellars,  or  forcing  them  to  sleep  out  in  extreme  cold 
weather;  (c)  infection  following  birth  of  the  young.  The 
close  association  of  the  disease  with  endocarditis  and  other 
diseases  of  serous  membranes  further  suggest  its  infectious 
nature. 

Pathology.— The  joint  capsule  is  more  or  less  distended 
with  a  yellowish  gelatinous-like  fluid  mixed  with  the  synovia. 
The  connective  tissue  is  infiltrated  with  the  same  material. 
Examination  of  the  synovial  membrane  itself  reveals  swelling, 
injection  and  hemorrhages.  The  cartilage  of  the  joint  is 
bluish  or  yellow  in  color  and  the  surface  roughened.  Chronic 
cases  show  marked  thickening  of  the  periarticular  tissue. 
Similar  changes  are  often  found  in  the  tendon  sheaths.  The 
musculature  shows  atrophy. 


:^64     ARTICULAR  RHEUMATISM— POLYARTHRITIS 

Symptoms.  The  condition  often  begins  suddenly  involving 
one  joint  or  several  at  the  same  time.  The  affected  ones  are 
very  painful,  the  animal  refusing  to  place  any  weight  on  the 
limb  and  holding  it  in  a  flexed  position.  The  joints  will  be 
hot  and  swollen.  Owing  to  the  pain  small  animals  usually 
remain  in  a  recumbent  position  and  refuse  to  arise.  The 
acute  symptoms  often  subside  after  a  week,  or  ten  days,  and 
eventually  develop  into  a  chronic  inflammation  with  deform- 
ity of  the  joints.  Favorite  locations  of  the  inflammation 
are  in  the  carpal,  stifle,  and  phalangeal  joints.  In  the  early 
stages  of  the  attack  there  is  fever,  which  may  reach  103°-105° 
F.  The  respirations  are  increased,  the  pulse  double  the 
normal  number.  The  animal  refuses  to  eat  in  most  cases. 
The  urine  is  reduced  in  quantity  and  dark  in  color. 

In  the  chronic  form  the  disease  assumes  the  character  of 
a  serosynovitis;  the  joint  capsule  is  very  much  thickened 
and  adhesions  take  place  between  the  joint  surfaces  in  a 
number  of  cases.  Ankylosis,  however,  is  rare.  There  is 
usually  but  little  fever  in  this  form  but  general  emaciation 
and  cachexia  will  be  prominent.  In  a  few  cases  complica- 
tions develop.  Inflammation  of  the  serous  membranes  is 
the  most  common.  This  is  indicated  by  a  greater  rise  in 
temperature  and  by  the  specific  symptoms  of  the  complicat- 
ing condition. 

Course.— In  the  acute  form  the  disease  usually  runs  for 
two  or  three  weeks.  Remissions  often  occur  at  different 
intervals  for  several  months  to  one  year.  In  many  cases  the 
attack  disappears  quite  suddenly  which  may  be  for  only  a 
short  time  or  permanently. 

Diagnosis. —This  may  be  difficult.  A  careful  examination 
must  always  be  made  to  differentiate  it  from  other  diseases 
affecting  the  joints.  It  should  be  borne  in  mind  that  articular 
rheumatism  comes  on  primarily  while  that  produced  by  other 
diseases  shows  the  primary  condition  elsewhere  before  the 
joints  become  affected. 

Prognosis.— Should  not  be  considered  too  favorable.  How- 
ever, in  the  dog  they  may  recover  completely.  Very  often 
the  condition  becomes  chronic  leading  to  permanent  deform- 


MUSCULAR  RHEUMATISM  365 

ity  of  the  joints.     Complications  may  also  follow,  such  as 
endocarditis  or  inflammation  of  other  serous  membranes. 

Treatment. —Treatment  in  small  animals  is  often  satis- 
factory by  the  use  of  large  doses  of  sodium  salicylate  (1.0  to 
2.0  daily).  After  two  to  three  days  the  temperature  falls 
almost  to  normal  and  the  general  condition  will  improve. 
Other  preparations  have  been  recommended,  as  salicylic 
acid  (intravenously),  salol,  or  acetanilid.  Local  applications 
to  the  joints  will  assist  in  giving  relief  from  the  pain,  and  in 
the  absorption  of  the  deposits.  lodin  liniments,  camphor 
oil,  or  mercuric  iodid  ointment,  any  one  of  which  may  be 
applied  alternately  with  hot  water  applications.  The 
animal  should  be  placed  in  a  moderately  warm  room,  where 
it  is  quiet,  and  provided  with  a  soft  bed.  In  the  chronic 
form,  massage  the  joints  thoroughly  daily  with  Lugol's 
ointment. 

MUSCULAR  RHEUMATISM. 

Definition.— A  primary  affection  of  the  muscles  (myositis) 
probably  of  infectious  origin.  It  occurs  commonly  in  dogs. 
Owing  to  the  fact  that  it  is  very  difficult  to  make  a  distinction 
between  muscular  rheumatism  and  so-called  "soreness"  and 
"stiffness"  of  the  muscles,  they  are  usually  classed  as  muscu- 
lar rheumatism.  The  number  of  cases  of  muscular  rheu- 
matism would  no  doubt  be  decreased  if  a  careful  examination 
were  made  in  all  cases  and  a  more  accurate  diagnosis  estab- 
lished. There  has  been  a  tendency  no  doubt  to  use  the  term 
muscular  rheumatism  in  a  too  inclusive  sense. 

Etiology.— The  immediate  cause  of  muscular  rheumatism 
is  probably  an  infection,  the  nature  of  which  has  not  been 
determined  up  to  the  present  time.  Several  factors  have  to 
do  with  the  development  of  the  disease:  (a)  Damp,  cold 
kennels,  and  exposure  to  cold  have  proved  decided  factors 
in  bringing  on  the  attacks.  Very  commonly  observed  in 
hunting  dogs  following  their  exposure  on  hunting  trips.  This 
is  especially  true  in  those  animals  that  have  been  pampered 
and  kept  in  warm  buildings  and  quarters,  (b)  Ptomain 
poisoning  and  intoxication  from  toxins  absorbed  from  the 
intestinal  tract  will  also  produce  it.  (c)  Certain  infectious 


366     ARTICULAR  RHEUMATISM— POLYARTHRITIS 

diseases  of  serous  membranes  will  bring  on  attacks  of  muscu- 
lar rheumatism  in  a  similar  manner  as  articular  rheumatism. 
(d)  Injuries  to  the  muscles,  overexertion  without  previous 
exercise,  will  produce  similar  symptoms.  This,  however, 
should  not  be  classed  as  muscular  rheumatism. 

Pathology.— On  examination  the  muscles  will  show  serous 
inflammation  with  infiltration  of  the  intramuscular  con- 
nective tissue.  Disintegration  and  fatty  degeneration  are 
found  in  most  cases.  The  muscular  tissue  shows  evidence 
of  hyperemia  and  swelling.  In  chronic  cases  the  fibrous 
connective  tissue  elements  are  thickened. 

Symptoms.— Pain  is  always  a  prominent  symptom.  This 
may  be  constant  in  severe  attacks  or  in  the  milder  forms 
periodic  and  recurrent.  In  dogs  the  condition  very  often 
comes  on  suddenly  without  any  prodromal  symptoms.  The 
attack  is  usually  transient  lasting  from  a  few  hours  to  several 
weeks,  and  is  very  apt  to  recur.  The  symptoms  of  muscular 
rheumatism  will  depend  somewhat  upon  the  groups  of  muscles 
affected.  Sometimes  the  muscles  of  the  head  and  neck  are 
involved ;  in  this  case  the  head  and  neck  will  be  more  or  less 
fixed,  the  animal  holding  the  head  in  a  rigid  position.  When 
manipulated  or  the  animal  made  to  move  indications  of  severe 
pain  are  noted.  In  other  cases  the  muscles  over  the  scapula 
will  show  the  primary  seat  of  the  disease.  This  is  often 
unilateral,  but  may  be  present  on  both  sides.  The  anterior 
limb  will  be  relaxed  or  the  animal  show  marked  lameness 
when  weight  is  placed  on  it.  When  bilateral  the  animal 
may  be  found  in  a  recumbent  position,  with  the  limbs 
straightened  out,  and  refuses  to  get  up.  The  patient  cries 
out  and  whines  when  the  muscles  are  palpated. 

In  involvement  of  the  muscles  of  the  back  (lumbago 
rheumatica)  the  animal  assumes  a  rigid  attitude,  very 
cautious  in  all  its  movements,  frequently  refusing  to  move 
and  when  forced  to  do  so  great  pain  is  manifest.  Occasionally 
the  patient  will  be  found  lying  down.  Manipulation  of  the 
muscles  over  the  region  produces  intense  pain.  When  the 
muscles  of  the  extremities  are  primarily  affected  the  animal 
lies  on  its  back  with  the  feet  upward,  whining  and  crying. 
Feces  and  urine  are  often  retained  when  the  abdominal 


MUSCULAR  RHEUMATISM  367 

muscles  are  affected.  The  various  functions  of  the  body  are 
interfered  with  owing  to  the  pain  from  the  disease.  The 
sensibility  of  the  skin  is  either  normal  or  hypersensitive.  As 
a  rule  no  appreciable  rise  in  temperature  is  noted.  The 
respirations  are  increased  and  may  be  shallow  when  the 
respiratory  muscles  are  affected.  The  pulse  may  be  increased 
materially,  due  to  the  pain  present.  The  general  condition 
of  the  animal  is  good  and  the  appetite  retained.  In  severe 
cases  animals  become  emaciated  from  the  disturbance  of  the 
functions.  Complications  occur  occasionally  in  the  form  of 
acute  inflammation  of  serous  membranes,  and  disturbances 
in  the  digestive  tract. 

Course. — The  acute  attack,  as  a  rule,  lasts  only  a  few  days 
to  one  week.  The  symptoms  may  disappear  entirely. 
Recurrence  of  the  condition  is  to  be  expected. 

Prognosis.— Complete  recovery  without  periodical  recur- 
rences of  the  disease  can  hardly  be  hoped  for.  Unless 
complications  develop  the  patient  will  apparently  recover 
from  the  attack. 

Treatment.— The  early  indications  in  the  treatment  are: 
Protection  of  the  patient  from  exposure,  relief  from  the 
pain  and  the  administration  of  antirheumatic  agents.  The 
animal  should  be  placed  in  a  moderately  warm,  dry  place 
with  a  soft  bed.  All  further  exposure  to  cold  and  dampness 
should  be  avoided.  Local  applications  to  the  affected 
muscles  are  recommended.  Massage  the  muscles  with  soap 
liniment,  camphor  liniment,  or  chloroform  liniment.  These 
should  be  applied  once  or  twice  daily.  Hot  towels  applied 
to  the  affected  area  often  give  relief  promptly.  Internally 
administer  sodium  salicylate  or  salicylic  acid  in  large  doses 
(0.9  to  1.5)  once  daily.  When  the  pain  is  intense  it  is 
advisable  to  control  it  by  subcutaneous  injections  of  morphin 
sulphate  (0.1  to  0.2).  This  may  be  repeated  in  twelve  to 
eighteen  hours  if  necessary.  Complications  as  they  arise 
should  be  treated.  In  cases  that  tend  to  become  chronic, 
potassium  iodid  is  highly  recommended  (0.2  to  0.4).  Ple- 
thoric animals  should  be  depleted  by  administering  saline 
laxatives  (magnesium  sulphate  8.0  to  12.0). 


308     ARTICULAR  RHEUMATISM— POLYARTHRITIS 


FRACTURE  OF  BONES. 

As  a  result  of  injuries  from  various  causes  small  animals 
are  particularly  prone  to  fractures  of  different  kinds.  The 
number  of  fractures  and  the  bones  affected  are  much  greater 
than  in  the  large  animals.  All  kinds  of  fractures  (partial, 
complete,  compound,  or  comminuted)  are  observed.  The 
larger  number  of  fractures  naturally  take  place  in  the  extrem- 
ities, although  fractures  of  the  skull  bones,  inferior  maxilla, 
ribs  and  vertebrte  are  not  uncommon.  The  causes  of  frac- 
tures are  varied,  but  the  greater  number  of  cases  result  from 
traumatism  (being  run  over  by  vehicles,  kicks,  falls,  jump- 
ing, gunshot  wounds,  bites  from  other  animals).  In  a  few 
cases  extreme  muscular  contraction  will  fracture  the  bones. 
Various  diseases  of  the  bones,  and  senility  predispose  to 
fractures.  The  following  are  the  more  common  fractures 
met  with : 

Cranial  Bones.— This  form  of  fracture  occurs  occasionally 
in  dogs.  The  writer  has  observed  six  cases  during  the  past 
ten  years. 

Etiology.— Practically  always  results  from  traumatism. 
Being  struck  by  sharp  or  blunt  objects,  run  over  by  automo- 
biles, kicks,  etc.,  are  the  most  frequent  causes. 

Symptoms.— Various  kinds  and  degrees  of  fractures  are 
recognized,  from  a  simple  fissuring  of  the  bones  to  penetrat- 
ing, depressed  or  compound  comminuted  fractures.  The 
symptoms  vary  with  the  degree  and  kind  of  fracture.  Simple 
fissuring  of  the  bones  may  not  produce  any  marked  symptoms 
unless  the  concussion  has  been  sufficient  to  cause  hemorrhage 
or  injury  to  the  membranes  of  the  brain.  The  presence  of  the 
wound  and  on  pressure  slight  movement  between  the  bones 
may  be  observed.  Penetrating  wounds  with  fracture  often 
produce  complications  of  hemorrhage  into  the  cranial  cavity 
or  direct  injury  to  the  structures  within.  Examination  of  the 
external  wound  and  carefully  probing  will  at  once  disclose 
the  actual  conditions.  Fractures  with  depression  of  a  frag- 
ment of  bone  cause  more  or  less  brain  disturbance  depending 
upon  the  location  of  the  fracture.  The  psychical  disturb- 


FRACTURE  OF  BONES  369 

ances  and  the  presence  of  the  wound  would  assist  in  making 
the  diagnosis.  If  there  is  doubt  in  regard  to  the  exact  con- 
ditions the  external  wound  can  be  opened  sufficiently  to 
examine  the  parts  direct.  Compound  and  comminuted 
fractures  show  the  presence  of  the  wound  and  the  opening 
through  the  cranial  bones.  Fragments  of  bone  may  be  found 
projecting  out  through  the  opening  or  downward  into  the 
cranial  cavity.  Probing  will  reveal  the  conditions.  The 
concussion  from  the  injury  may  produce  unconsciousness 
for  a  time  even  though  but  little  damage  has  been  done  the 
bones  themselves.  Death  occurs  suddenly  in  many  instances 
when  the  brain  is  severely  injured  or  sudden  severe  hemor- 
rhage takes  place.  Careful  examination  should  be  made  in 
all  cases  in  order  to  establish  a  positive  diagnosis. 

Prognosis.— The  prognosis  should  not  be  considered  too 
favorable  on  account  of  the  danger  of  brain  complications. 

Treatment.— The  treatment  will  depend  upon  the  kind  of 
fracture.  In  simple  fissuring  of  the  bone  no  treatment  is 
necessary,  except  for  the  contusion  of  the  skin  and  muscular 
tissue  covering  the  bone.  Penetrating  fractures  are  best 
treated  by  opening  the  external  wound,  examining  the 
fractured  portions  and  elevating  them  carefully  with  a  scalpel 
or  stiff  probe.  Clean  the  wound  thoroughly  and  suture  the 
skin  covering  it  with  iodoform  collodion. 

Depression  of  the  skull  bones  should  have  prompt  treat- 
ment to  relieve  the  pressure  from  the  brain  and  membranes. 
This  is  best  done  by  making  external  incision,  and  if  necessary 
a  small  opening  through  the  bones  so  that  an  instrument  can 
be  inserted  to  elevate  them  to  their  normal  position.  Strict 
aseptic  precautions  should  be  observed  in  the  operation. 
Suture  the  outside  wound.  In  compound  comminuted  frac- 
tures all  fragments  of  bone  should  be  removed,  conserving  as 
much  as  possible,  and  a  protective  dressing  applied  to  the 
parts. 

Fracture  of  the  Inferior  Maxilla.— Fracture  of  this  bone 
occurs  very  often  in  dogs  and  cats.  The  points  of  fracture 
are  usually  at  the  symphysis,  in  front  of  the  premolars,  or 
posterior  to  the  molars.  Frequently  the  fracture  is  bilateral, 
but  in  most  cases  involves  one  side. 
24 


370     ARTICULAR  RHEUMATISM— POLYARTHRITIS 

Etiology.— Traumatism  is  often  the  cause  of  the  fracture. 
It  can  result  from  extraction  of  teeth.  It  may  follow  alveolar 
periostitis,  or  exfoliation  of  a  portion  of  the  bone  weakening 
the  jaw  at  this  point.  Extreme  pressure  from  biting  on  hard 
objects  (stones  of  large  size)  can  be  a  cause.  Diseases  of  the 
bones  (fragilitas  ossium)  predisposing  them  to  fracture. 

Symptoms.— Difficulty  in  eating  is  the  first  symptom 
noticed.  Other  symptoms  are  displacement  of  the  maxilla 
at  the  point  of  fracture,  excessive  salivation,  and  enlarge- 
ment on  the  side  affected.  On  examination  crepitus  and 
movement  between  the  portions  of  bone  will  be  recognized 
at  once, 

Prognosis. — Owing  to  the  complications  of  infection,  and 
the  difficulty  in  keeping  the  parts  quiet,  the  prognosis  is 
unfavorable. 

Treatment.— Various  methods  of  treatment  have  been 
tried.  In  fissuring  without  laceration  of  the  mucous  mem- 
brane it  is  advisable  to  try  wiring  them  together  with  silver 
wire  using  the  teeth  as  fixed  points.  In  compound  fractures 
when  infection  takes  place  treatment  is  usually  unsatis- 
factory. Fixing  the  maxilla  by  the  use  of  a  leather  pad  or 
muzzle  in  contact  with  the  superior  maxilla,  disinfecting  the 
mouth  twice  daily,  and  giving  liquid  foods  have  proved  the 
most  satisfactory  treatment. 

In  comminuted  fractures  where  fragments  of  bone  must 
be  removed  but  little  can  be  expected  of  any  treatment. 

Fracture  of  the  Vertebrae.— The  points  at  which  fractures 
most  commonly  occur  are  in  the  cervical,  lumbar,  and  coccy- 
geal  segments. 

Etiology.— Most  cases  result  from  traumatism. 

Symptoms.— The  symptoms  will  depend  upon  the  kind  of 
fracture,  whether  it  is  confined  to  portions  of  the  vertebra? 
outside  of  the  canal  or  involves  the  canal  with  the  spinal  cord. 
Crepitus  and  pain  on  manipulation  of  the  parts  are  prominent 
symptoms.  Should  the  fracture  be  confined  to  the  lateral 
processes  no  other  symptoms  will  be  observed.  In  complete 
fracture  of  the  cervical  vertebrae  with  involvement  of  the 
cord,  death  may  result  in  a  few  minutes,  or  hours.  Complete 
paralysis  exists  posterior  to  the  point  of  the  fracture.  Fract- 


FRACTURE  OF  BONES  371 

ure  in  the  lurnbar  region  produces  paraplegia  and  paralysis 
of  the  posterior  portion  of  the  body.  Differentiation  between 
hemorrhage  in  the  canal,  edema  of  the  cord  and  fractures  is 
often  difficult  and  can  be  determined  only  by  the  progress 
of  the  case.  Fractures  of  the  coccygeal  vertebrae  are  easily 
determined  by  crepitus  and  the  increased  mobility  of  the 
parts. 

Prognosis.  —  Complete  fracture  of  the  vertebrae  is  unfavor- 
able. Fracture  of  the  lateral  processes  or  coccygeal  vertebra? 
is  favorable. 

Treatment. — No  treatment  is  possible  in  fracture  of  the 
cervical  and  lumbar  vertebra3.  The  animal  should  be  placed 
in  a  quiet,  comfortable  place.  Give  nourishing  food.  If 
necessary  artificial  feeding  should  be  carried  out.  Laxatives 
are  also  necessary.  Simple  fracture  of  the  coccygeal  vertebrae 
is  best  treated  by  bandaging.  If  complications  arise  .or  a 
compound  fracture  is  present  amputation  may  be  necessary 
at  the  point  of  fracture,  or  slightly  above. 

Fracture  of  the  Ribs.— This  is  found  most  commonly  in 
dogs  and  is  of  very  frequent  occurrence. 

Etiology.— Produced  in  many  cases  by  being  run  over  by 
vehicles,  struck  by  objects,  or  kicked. 

Symptoms.— One  or  two  ribs  may  be  fractured  without 
producing  marked  symptoms.  This  is  especially  true  in 
partial  and  in  simple  fractures.  Some  will  show  displace- 
ment and  enlargement  at  the  point  of  fracture.  Crepitus  is 
hard  to  distinguish  in  all  patients.  Compound  fractures  may 
cause  injury  to  the  pleura  or  lung  tissue.  Examination  should 
be  made  carefully. 

Prognosis.— Favorable  unless  complications  involving  the 
pleura  and  lungs  develop. 

Treatment.— Most  cases  do  not  require  any  treatment. 
Keep  the  animal  quiet.  A  bandage  applied  around  the  thorax 
to  assist  in  keeping  the  parts  fixed  might  be  used.  Compli- 
cations involving  the  pleura  and  lungs  should  be  treated 
according  to  the  conditions. 

Fracture  of  the  Scapula.— This  is  not  of  frequent  occur- 
rence. In  dogs  the  points  of  fracture  most  common  are 
through  the  neck  and  glenoid  cavity.  In  young  animals 


372     ARTICULAR  RHEUM  AT  ISM— POYL  ARTHRITIS 

separation  takes  place  frequently  between  the  epiphyses  and 
diaphyses. 

Etiology.— From  injuries  and  diseases  of  the  bones. 

Symptoms.— Sudden  development  of  lameness.  The  limb 
usually  hangs  inert  and  cannot  be  moved  -upward  and  for- 
ward. Examination  will  reveal  the  fracture. 

Treatment.— No  satisfactory  treatment  can  be  applied 
owing  to  the  location  of  the  scapula.  Dogs,  when  well  cared 
for  and  protected,  will  recover  without  special  treatment. 
Dogs  protect  the  limbs  better  than  any  other  animal.  Stim- 
ulating liniments  might  be  applied  over  the  area  (soap  lini- 
ment, iodin  liniment). 

Fracture  of  the  Humerus.—  Owing  to  the  exposed  position 
of  the  humerus  it  is  frequently  fractured.  In  young  animals 
separation  of  the  epiphyseal  and  diaphyseal  portions  is  not 
uncommon.  It  has  been  observed  that  the  lower  end  of  the 
bone  is  more  often  fractured  than  any  other  portion.  Fract- 
ure of  the  condyles  occurs  with  considerable  regularity. 

Etiology.— Traumata  of  various  kinds  produce  the  majority 
of  cases.  It  occasionally  happens  that  both  the  humerus 
and  scapula  are  fractured  at  the  same  time., 

Symptoms.— When  unilateral  fracture  of  either  the  epi- 
physeal or  diaphyseal  portions  of  the  bone  takes  place  the 
animal  cannot  support  any  weight  on  the  limb.  It  will  hang 
free  and  limp.  Should  both  be  fractured  the  animal  rests  its 
weight  on  its  haunches,  or  assumes  a  recumbent  position. 

Diagnosis.  — Examination  of  the  limb  will  at  once  make 
the  diagnosis  positive.  It  is  very  rare  to  find  a  compound 
fracture. 

Prognosis. —Favorable. 

Treatment.— The  application  of  bandages  is  very  difficult. 
This  is  especially  true  when  the  fracture  occurs  in  the  upper 
portion  of  the  bone.  Experience  has  proved  that  good 
results  follow  without  splints  or  bandages.  Occasionally  a 
false  union  of  cartilage  or  fibrous  connective  tissue  will  result 
forming  a  pseudo-articulation. 

Fracture  of  the  Radius  and  Ulna.— This  is  the  most  fre- 
quent of  all  fractures  in  the  anterior  limb  of  the  dog.  All 
small  animals  are  affected  in  a  similar  manner.  Fracture 


FRACTURE  OF  BOXES  373 

usually  occurs  in  both  bones  simultaneously.  When  one 
bone  is  fractured  it  is  usually  the  olecranon  portion  of  the 
ulna.  The  lower  third  of  the  bones  is  the  seat  of  the  majority 
of  fractures. 

Etiology.— Practically  always  result  from  injuries.  Some 
few  cases  are  due  to  diseases  of  the  bones. 

Symptoms.— Inability  to  place  weight  on  the  limb  and 
angularity  at  the  point  of  fracture.  There  are  swelling  and 
distortion  of  the  limb.  When  the  olecranon  is  fractured  the 
distortion  will  be  marked  at  the  point  of  the  elbow.  Crepitus 
and  free  movement  between  the  fractured  portions  will  be 
apparent  on  manipulation. 

Treatment.— Wrapping  the  limb  with  ordinary  linen  band- 
age is  recommended  until  the  swelling  subsides.  Plaster 
bandages  are  unsatisfactory  during  the  first  few  days  owing 
to  the  change  in  the  size  of  the  parts  from  swelling.  A  pad 
of  cotton  should  be  applied  to  protect  the  skin  from  pressure 
necrosis  and  to  allow  for  swelling  to  take  place,  then  strips 
of  cardboard  softened  by  placing  in  w7arm  water  for  a  few 
minutes,  and  over  this  a  linen  bandage.  The  patient  should 
be  observed  to  determine  whether  the  bandage  has  been 
drawn  too  tight  or  has  become  loose.  Should  the  foot  be 
found  swollen  it  indicates  that  the  bandage  is  too  tight  and 
free  circulation  of  blood  interfered  with.  It  should  be 
loosened.  After  a  few  days  a  plaster  bandage  can  be  applied 
if  thought  advisable.  It  should  remain  in  position  for  a  few 
weeks  to  ensure  complete  union.  Uniting  the  bone  at  point 
of  fracture  with  silver  wire  has  been  tried  with  varying 
degrees  of  success.  Radial  fractures  usually  make  prompt 
and  complete  recoveries. 

Fracture  of  the  Metacarpal  and  Phalangeal  Bones.— These 
bones  are  fractured  from  the  same  causes  as  mentioned  under 
the  others. 

Diagnosis.  — This  is  made  by  careful  palpation. 

Treatment.  — Bandage  as  in  fracture  of  the  radins  and  ulna. 
In  compound  fractures  it  is  sometimes  necessary  to  amputate 
a  portion  of  the  limb  or  toes. 

Fracture  of  the  Pelvis.  — Fracture  of  this  bone  is  quite 
common  in  small  animals,  and  presents  a  variety  of  condi- 


374    ARTICULAR  RHEUMATISM—POLYARTHRITIS 

tions.  The  most  common  points  of  fracture  are  through 
the  symphysis,  external  angles  of  the  ilium,  or  through  the 
acetabulum.  Both  unilateral  and  bilateral  fractures  are 
observed.  Complications  are  common  following  fracture  of 
the  pelvis,  owing  to  the  injury  of  adjacent  structures.  Injury 
to  the  nerves  or  bloodvessels  is  most  common. 

Etiology.— Pelvic  fractures  are  produced  very  frequently 
by  being  run  over,  struck  by  objects,  kicks,  or  falling. 

Symptoms.— The  symptoms  will  vary  somewhat  depending 
on  the  degree  of  fracture,  its  location,  and  the  complications. 
Deformity  of  the  pelvis  is  present  in  fracture  of  the  external 
angle  of  the  ilium.  Crepitation  and  movement  of  the  parts 
can  be  detected.  Fracture  through  the  symphysis  is  evi- 
denced by  the  unnatural  gait  of  the  animal,  the  abduction 
of  the  limbs,  and  the  separation  which  can  be  detected  on 
palpation  between  the  fractured  portions.  It  is  sometimes 
difficult  to  make  a  positive  diagnosis  in  fracture  at  other 
points  on  account  of  the  smallness  of  the  openings  through 
which  the  examination  must  be  made.  Complicating  symp- 
toms should  be  examined  for  in  all  cases. 

Prognosis.— Unless  complications  of  hemorrhage  and 
destruction  of  some  of  the  nerves  occur,  the  prognosis  is 
considered  favorable.  Different  degrees  of  deformity  will  be 
met  with  which  should  be  considered  in  the  prognosis.  The 
condition  is  serious  in  breeding  animals  on  account  of  the 
deformity  narrowing  the  pelvic  canal.  Such  animals  should 
be  given  a  careful  examination  in  this  regard. 

Treatment.— But  little  can  be  done  in  the  way  of  treatment. 
Union  usually  takes  place  promptly  by  giving  the  animal 
protection  for  a  few  weeks.  Various  methods  have  been  tried 
to  approximate  fractures  of  the  pelvis  but  with  little  success. 

Fracture  of  the  Femur.— Fracture  of  the  femur  occurs 
often  in  dogs,  cats  and  rabbits.  The  majority  of  cases  are 
found  involving  the  lower  third  of  the  bone.  Some  few  cases 
are  observed  in  the  upper  portion,  even  involving  the  head 
of  the  femur. 

Etiology.— Injuries  and  accidents  account  for  the  larger 
number  of  cases.  Diseases  of  the  bone  (fragilitas  ossium  and 
osteomalacia)  predispose  to  fracture. 


FRACTURE  OF  BONES  375 

Symptoms.— In  practically  every  case  the  limb  is  held  off 
the  ground,  freely  moved  in  all  directions,  and  appears  shorter 
than  normal.  Care  should  be  made  to  differentiate  between 
fracture  and  dislocation  of  the  head  of  the  femur.  Examina- 
tion of  the  limb  will  reveal  the  point  of  fracture. 

Diagnosis.— Fissuring  of  the  bone  may  present  some  diffi- 
culty but  in  other  cases  the  diagnosis  is  easy. 

Prognosis.— Favorable.  Union  of  the  bones  may  result  in 
some  permanent  distortion,  such  as  shortening  the  limb,  or  a 
certain  amount  of  angularity. 

Treatment.— An  attempt  should  be  made  to  bandage  the 
limb  to  keep  the  bones  in  apposition  as  nearly  as  possible. 
A  temporary  muslin  and  splint  bandage  should  be  used  until 
the  swelling  subsides.  Later  a  better  and  more  permanent 
dressing  may  be  applied.  As  a  rule  union  takes  place  quite 
promptly  and  without  much  distortion. 

Fracture  of  the  Patella.— This  bone  is  very  rarely  fractured 
in  small  animals.  Careful  palpation  over  the  region  would 
reveal  the  condition.  No  treatment  other  than  bandaging 
can  be  applied. 

Fracture  of  the  Tibia  and  Fibula.— These  bones  are  the 
seat  of  all  types  of  fractures.  Very  common  in  dogs  and 
rabbits.  The  symptoms,  prognosis  and  treatment  are  similar 
to  those  given  for  the  radius  and  ulna.- 


CHAPTER  II. 
DISEASES  OF  THE  ARTICULATIONS. 

THE  various  articulations  in  small  animals  are  subjected 
to  a  variety  of  conditions. 

WOUNDS  OF  THE  ARTICULATIONS. 

Punctured  wounds  and  various  kinds  of  incised  wounds 
are  frequently  met  with.  In  some  cases  the  adjacent  struct- 
ures may  be  severely  injured  complicating  the  condition. 
Further  classification  should  be  made  into  aseptic  and  septic 
wounds.  From  a  practical  standpoint  it  is  important  to 
examine  the  wounds  carefully  to  make  these  distinctions. 

Etiology.  —  It  is  selfevident  that  '  these  wounds  occur 
through  various  accidents  and  injuries  to  which  the  animals 
are  subjected. 

Symptoms.— The  animal  will  favor  the  joint  affected  and 
refuse  to  walk  on  the  limb.  A  thin,  serous  discharge  (synovia) 
is  noted  coming  from  the  wound.  The  amount  of  pain  and 
swelling  will  not  be  marked  in  the  early  stages.  However, 
if  infection  is  introduced,  these  symptoms  develop  very 
rapidly.  Pus  soon  makes  its  appearance,  the  joint  becomes 
very  hot  and  sensitive,  and  general  symptoms  of  fever,  loss 
of  appetite,  are  observed. 

Diagnosis.— This  is  made  by  carefully  examining  the  dis- 
charge and  by  probing  the  wound  with  a  sterile  probe. 

Prognosis.— Should  not  be  made  very  favorable  in  any  case, 
owing  to  the  possibility  of  destruction  of  the  joint,  or  anky- 
losis.  Non-infected  wounds  usually  heal  without  difficulty. 

Treatment.— After  learning  the  facts  concerning  the  in- 
volvement of  the  joint,  strict  antiseptic  precautions  should 
be  taken,  and  all  means  employed  to  prevent  infection. 


SPRAINS  AND  INJURIES  TO  THE  ARTICULATIONS    377 

Shave  the  hair  from  the  area  and  disinfect  the  surface  with 
bichlorid  of  mercury  and  glycerin  (1  to  500).  Saturate  gauze 
or  cotton  with  this  solution  and  apply  under  a  bandage,  if 
possible.  When  infection  is  already  present  it  is  advisable 
to  open  the  wound  so  that  adequate  drainage  will  be  brought 
about.  Use  the  same  solution  as  above  and  inject  it  into  the 
articulation.  Apply  a  protective  dressing.  Repeat  this 
treatment  at  least  twice  daily. 

SPRAINS  AND  INJURIES  TO  THE  ARTICULATIONS. 

In  the  larger  number  of  injuries  occurring  in  small  animals 
it  frequently  happens  that  the  structures  around  the  joints 
are  torn  or  otherwise  injured  without  an  external  wound. 
This  condition  may  occur  in  any  of  the  articulations.  As 
soon  as  the  injury  occurs  the  synovial  secretion  is  increased 
in  amount,  and  the  adjacent  tissues  are  often  edematous. 

Symptoms.— The  condition  develops  suddenly  following 
injury,  or  violent  exercise.  The  articulation  soon  becomes 
enlarged,  very  hot  and  painful  to  the  touch.  The  patient 
refuses  to  bear  any  weight  on  the  limb.  Careful  examina- 
tion must  be  made  to  differentiate  sprains  from  fracture  or 
dislocation.  Distortion,  increased  movement,  and  crepitus 
found  in  fractures  are  absent  in  this  condition.  The  normal 
position  of  the  bones  would  exclude  dislocation.  In  severe 
cases  the  swelling  may  be  so  extensive  as  to  interfere  with 
making  a  positive  and  early  diagnosis. 

Prognosis. — Most  cases  of  sprains  recover. 

Course.— The  course  depends  upon  the  degree  of  injury. 

Treatment.— The  animal  should  be  confined  in  a  quiet 
place  for  several  days.  Cold  applications  in  the  form  of  cold 
water,  or  better,  ice  packs,  should  be  applied  during  the 
first  twenty-four  to  thirty-six  hours.  The  packs  are  changed 
frequently  to  keep  up  the  refrigeration.  Follow  this  treat- 
ment with  hot  water,  or  liniment  (iodin  liniment,  white 
liniment)  applied  once  or  twice  daily.  Massage  the  parts 
thoroughly.  The  latter  treatment  should  be  continued  for 
two  to  three  weeks,  if  necessary. 


378  DISEASES  OF  THE  ARTICULATIONS 


DISLOCATION  OF  THE  ARTICULATIONS.     LUXATION. 

Dislocation  of  the  various  articulations  in  dogs,  cats  and 
rabbits  is  a  common  occurrence.  Birds  often  have  luxation 
of  the  joints  of  the  wings. 

The  following  are  the  most  common  dislocations  found  in 
small  animals: 

Temporomaxillary.— This  occurs  more  frequently  in  dogs 
than  in  any  other  animal.  • 

Etiology.— Resulting  in  most  cases  from  extreme  opening 
of  the  mouth,  either  from  being  forcibly  pulled  open,  or  from 
large  objects  being  taken  into  the  mouth.  The  condition 
may  be  either  unilateral  or  bilateral. 

Symptoms.— Fixation  of  the  lower  maxilla  either  laterally 
(in  case  of  unilateral  luxation),  or  downward  and  forward 
(bilateral  luxation).  Saliva  flows  from  the  mouth  freely,  the 
animal  is  unable  to  move  the  maxilla,  or  only  slightly,  and 
shows  considerable  anxiety  and  pain.  Pawing  at  the  mouth 
with  the  forefeet,  rubbing  the  parts  against  objects,  and 
carrying  the  head  in  abnormal  positions,  are  prominent 
symptoms.  Patients  showing  these  symptoms  should  be 
handled  carefully,  as  in  some  respects  they  are  not  unlike 
dumb  rabies.  Examination  will  easily  reveal  the  differential 
features. 

Prognosis. — Usually  .favorable,  except  when  the  case  is  of 
too  long  standing  and  fracture  of  the  bones  is  present.  There 
is  always  the  possibility  of  a  recurrence. 

Treatment.— Reduction  of  the  dislocation  should  be  made 
early.  The  animal  should  be  anesthetized  (morphin  sulphate, 
0.1  to  0.2),  placed  on  a  suitable  table  in  the  dorsal  position, 
and  by  using  a  fulcrum  inserted  between  the  teeth,  the  jaws 
are  forced  apart  by  bringing  the  incisors  together.  By 
careful  manipulation  the  bones  are  replaced  in  their  normal 
position.  Considerable  patience  is  often  necessary  to  accom- 
plish this.  If  fractures  are  present  but  little  can  be  done. 
Use  artificial  feeding  of  liquid  foods  for  a  few  days.  It  is 
advisable  to  tape  the  mouth  shut  for  a  few  days  until  the 
articulations  are  normal  again. 


DISLOCATION  OF  THE  ARTICULATIONS— LUXATION  379 

Vertebral. — Dislocation  unattended  by  fracture  is  rare. 
The  articulations  are  so  arranged  anatomically  that  luxation 
without  fracture  is  not  liable  to  occur.  Partial  luxation  is 
met  with  occasionally  and  is  diagnosed  by  the  position  of 
the  head  and  curvature  of  the  vertebrae.  Straightening  the 
head  and  neck  should  be  attempted. 

Scapulohumeral.  —Owing  to  the  position  of  the  articulation 
and  its  anatomical  structure  complete  luxation  is  not  com- 
mon. The  articulation  is  capable  of  rather  extensive  move- 
ment without  dislocation. 

Etiology.  — It  is  brought  about  by  excessive  flexion  of  the 
joint  from  injuries  and  accidents.  The  luxation  is  usually 
forward  and  inward. 

Symptoms.—  The  condition  occurs  suddenly  and  distortion 
of  the  joint  is  apparent  at  once.  The  joint  is  held  in  a  flexed 
position  and  distention  is  practically  impossible.  The  limb 
is  much  shorter  than  normal.  Examination  of  the  articula- 
tion reveals  the  head  of  the  humerus  forward  producing  an 
enlargement  anteriorly  and  a  depression  posteriorly.  Animals 
show  pain  on  manipulation  of  the  joint. 

Prognosis.— In  complete  luxation  the  prognosis  is  favorable 
wThen  taken  early  but  later  when  swelling  takes  place  reduc- 
tion is  difficult,  and  the  joint  capsule  will  rarely  resume  its 
normal  condition.  Partial  luxations  are  favorable. 

Treatment.— The  animal  should  be  anesthetized  (morphin 
sulphate,  0.1  to  0.2),  placed  on  the  table  in  lateral  recumbency 
with  the  affected  articulation  presented .  Extend  the  humerus 
and  push  backward  on  the  head  of  the  humerus.  Usually 
replacement  will  take  place  without  much  difficulty.  Apply 
a  bandage  for  a  few  days  to  protect  the  part.  Massage  and 
a  stimulating  liniment  should  be  applied  around  the  joint. 

Humero-radio-ulnar.  —Luxation  of  this  articulation  may  be 
partial  or  complete.  Various  conditions  can  be  found  owing 
to  the  anatomical  structure  of  the  joint.  The  dislocation 
may  be  between  the  humerus  and  radius  or  between  the 
radius  and  ulna.  In  some  cases  all  of  the  structures  are 
involved.  The  dislocation  may  take  place  to  the  inside  or 
outside  depending  upon  the  cause  of  the  condition.  When 
dislocation  occurs  there  is  nearly  always  a  tearing  or  stretch- 


380  DISEASES  OF   THE  ARTICULATIONS 

ing  of  the  ligamentous  attachments  around  the  joints.  A 
congenital  dislocation  is  sometimes  observed. 

Etiology.— The  condition  is  brought  about  by  injuries,  such 
as  blows  from  the  outside  or  inside,  extreme  flexion  or  exten- 
sion of  the  joint,  falling,  or  jumping.  Frequently  the  limb 
is  given  a  sudden  twist  by  the  foot  being  caught  when  the 
animal  is  in  motion,  or  pulling  backward  to  free  itself. 

Symptoms.— Distortion  of  the  articulation  is  noted,  and 
the  lower  limb  in  an  abnormal  position,  either  abducted  or 
adducted.  There  is  an  enlargement  present  on  one  side  and 
a  corresponding  depression  on  the  opposite.  The  limb 
appears  short,  and  the  animal  refuses  to  place  any  weight 
on  it  when  in  motion  or  at  rest.  Examination  reveals  the 
joint  to  be  hot  and  painful  when  manipulated.  The  dis- 
placed bone  can  easily  be  palpated,  and  the  luxation  deter- 
mined. 

Prognosis.— Not  very  favorable  owing  to  the  injury  to  the 
annular  ligaments,  and  the  possibility  of  a  return  of  the 
condition. 

Treatment.  — Reduction  of  the  dislocation  should  be  made 
under  general  anesthesia.  The  method  of  procedure  will 
depend  upon  the  dislocation.  As  a  rule  but  little  difficulty 
will  be  experienced  in  bringing  the  parts  back  to  their  normal 
position.  After  reduction  of  the  luxation  the  parts  should 
be  bandaged  to  hold  them  in  position.  The  bandage  should 
be  left  in  place  for  two  or  three  weeks,  or  until  the  annular 
ligaments  are  united.  Congenital  luxation  is  unsatisfactory 
from  the  standpoint  of  treatment.  Wiring  of  the  bones 
might  be  tried  in  cases  that  cannot  be  kept  in  position  by 
bandaging. 

Radio-ulnar-carpal.— From  violent  injury  luxation  of  this 
articulation  may  take  place.  The  annular  ligaments  become 
torn  allowing  the  articular  surfaces  to  be  displaced. 

Symptoms.  — Distortion  of  the  articulation  either  forward 
or  backward  is  most  common. 

Diagnosis.— The  diagnosis  is  not  difficult  when  a  careful 
examination  is  made. 

Treatment.— Reduction  of  the  luxation  is  easy,  but  it 
requires  several  weeks  before  the  animal  will  be  able  to  use 


DISLOCATION  OF  ARTICULATIONS— LUXATION     381 

the  limb.    Protect  the  joint  by  placing  a  pad  of  cotton  under 
a  bandage.    Keep  the  bandage  on  for  two  or  three  weeks. 

Phalangeal.  —  Dislocation  is  very  common  and  results  from 
traumata.  A  careful  examination  should  always  be  made 
to  differentiate  luxations  from  fractures,  and  to  definitely 
determine  the  joint  displaced.  They  should  be  reduced  as 
early  as  possible  and  a  bandage  applied.  Keep  the  bandage 
in  position  for  two  to  three  weeks. 

Coxofemoral.  — This  is  one  of  the  most  common  disloca- 
tions in  dogs,  cats  and  rabbits.  It  may  be  partial  or  com- 
plete. When  partial  the  damage  is  mainly  in  connection 
with  the  capsular  ligament,  while  in  complete  luxation  the 
entire  joint  structure  and  the  adjacent  tissues  are  involved. 

Etiology.— Being  struck  by  objects,  run  over  by  vehicles, 
and  having  the  foot  caught  in  traps,  etc.,  are  the  most  com- 
mon causes.  Extreme  extension  of  the  limb  from  any  cause 
may  bring  it  about. 

Symptoms.— The  most  frequent  form  of  luxation  is  forward 
and  upward.  The  animal  is  found  with  the  limb  fixed  in  a 
backward,  adducted  position,  and  refuses  to  place  any  weight 
on  it.  An  enlargement  will  be  noted  just  anterior  to  the 
normal  position  of  the  joint,  and  on  palpation  the  head  of 
the  femur  can  be  felt.  Manipulation  of  the  limb  will  at  once 
reveal  the  condition.  Luxation  into  the  foramen  ovale  is 
not  common  but  occurs  in  a  small  percentage  of  cases.  The 
limb  appears  longer  than  normal,  is  slightly  abducted,  and 
the  stifle  joint  is  turned  outward.  Adduction  of  the  limb 
is  difficult  and  impossible  to  the  normal  degree.  Palpation 
of  the  parts  will  easily  diagnose  the  condition. 

A  backward,  upward  luxation  occurs  occasionally  and  the 
position  of  the  limb  is  forward  and  inward,  with  an  enlarge- 
ment present  on  the  posterior  aspect  of  the  joint.  (  areful 
examination  will  determine  the  relationship  of  the  parts.  In 
partial  luxation  the  animal  is  able  to  move  the  limb  and 
shows  lameness  but  very  little  deformity.  Chronic  conditions 
become  accommodated  to  the  movements  of  the  anim 
through  the  formation  of  a  pseudo-articulation. 

Prognosis.- Rather  unfavorable  for  a  complete  recovery. 
Early  cases  are  much  more  favorable  than  those  of  a  few  days 
or  weeks  standing. 


382  DISEASES  OF   THE  ARTICULATIONS 

Treatment.— Treatment  should  be  applied  as  early  as  pos- 
sible. -Anesthetize  the  animal  and  effect  replacement  by 
manipulation  of  the  limb  according  to  the  character  of  the 
luxation.  The  principle  involved  is  to  extend  the  articulation 
in  whatever  direction  is  necessary  so  that  the  head  of  the 
femur  can  be  returned  to  the  acetabulum.  Very  little  can 
be  done  in  after-treatment  except  keeping  the  animal  quiet 
for  several  days.  Mechanical  appliances  to  hold  the  bones 
in  position  have  not  proved  satisfactory.  Little  can  be 
expected  in  the  treatment  of  chronic  cases. 

Patellar.— This  occurs  most  frequently  in  the  dog.  The 
ligaments  of  the  patella  are  not  very  well  developed  outside 
of  the  middle  one.  Therefore,  displacement  is  more  liable  to 
occur  laterally.  Experience  has  shown  that  internal  displace- 
ment is  by  far  the  most  common. 

Etiology.— The  anatomical  structure  of  the  patellar  liga- 
ments and  the  joint  in  particular  make  displacement  easy 
from  excessive  exertion  or  injuries.  In  some  breeds  the 
internal  femoral  ridge  of  the  patellar  groove  is  very  small; 
therefore  internal  displacement  is  of  common  occurrence. 

Symptoms.— The  limb  is  held  in  a  flexed  position,  and  the 
patient  has  difficulty  in  supporting  weight.  The  flexion  is 
most  apparent  at  the  stifle  joint.  The  position  of  the  limb 
is  somewhat  characteristic,  the  stifle  joint  adducted,  the 
hock  rotated  outwardly,  and  the  lower  portion  of  the  limb 
carried  toward  the  median  line.  Examination  of  the  stifle 
joint  will  reveal  the  misplaced  patella.  When  the  condition 
is  bilateral  the  animal  will  show  a  crouching  attitude,  and 
will  have  considerable  difficulty  in  maintaining  the  standing 
position.  The  animal  moves  with  great  difficulty  in  bilateral 
dislocation. 

Prognosis.— The  prognosis  should  not  be  considered  favor- 
able owing  to  the  difficulty  in  keeping  the  parts  quiet  and 
the  possibility  of  a  recurrence  of  the  condition.  Very  often 
there  is  a  tendency  for  the  condition  to  become  chronic. 

Treatment.— Replacement  of  the  patella  presents  very  little 
difficulty;  therefore  the  problem  of  keeping  the  patella  in 
position  until  the  ligaments  assume 'their  normal  condition 
is  to  be  the  principal  aim  in  treatment.  Replacement  is 


INFLAMMATION  OF  THE  SYNOVIAL  MEMBRANE    383 

affected  by  extension  of  the  joint  which  will  allow  the  patella 
to  be  pulled  back  to  its  normal  position.  Apply  linen  bandage 
in  order  to  retain  the  parts  in  their  normal  position.  The 
animal  should  be  kept  quiet  for  several  days.  A  plaster 
bandage  might  be  used  to  advantage. 

Tibiotarsal.  —  This  is  not  very  common  in  small  animals. 
When  it  does  occur  it  is  accompanied  by  rupture  of  the  liga- 
ments or  fracture  of  some  of  the  bones.  A  careful  examination 
should  be  made  to  determine  the  conditions  as  accurately  as 
possible.  Linen  bandage  should  be  applied  for  the  first  few 
days,  followed  by  a  plaster  bandage  if  necessary. 

Caudal  Vertebrae.— The  larger  breeds  of  dogs  with  long 
tails  (Great  Dane,  greyhound,  etc.)  are  the  most  frequent 
sufferers.  Examination  of  the  parts  will  reveal  the  condition. 
A  bandage  applied  rather  firmly  and  kept  in  position  for 
several  days  will  correct  the  dislocation. 

INFLAMMATION    OF    THE    SYNOVIAL  MEMBRANE  AND 
ARTICULATIONS.     SYNOVITIS.     ARTHRITIS. 

Definition.— An  inflammation  of  the  synovial  membrane 
and  articular  surfaces.  The  conditions  may  be  acute  or 
chronic.  Very  often  the  entire  joint  will  be  inflamed  (syno- 
vitis  and  arthritis).  It  is  very  difficult  to  make  a  distinction 
between  these  two  conditions. 

Etiology.— Most  cases  result  from  sprains  and  contusions 
of  the  joint.  Few  result  from  infection  (pyogenic).  The 
infection  usually  gains  entrance  through  wounds  of  the  syno- 
vial membrane. 

Symptoms.  -Enlargement  of  the  joint,  extreme  sensitive- 
ness, and  increased  local  temperature  are  characteristic 
symptoms.  The  animal  cannot  use  the  limb  to  any  extent. 
Examination  should  be  made  carefully  to  differentiate  it 
from  articular  rheumatism. 

Prognosis.  — Favorable  in  cases  resulting  from  sprains  and 
bruises;  unfavorable  in  infected  joints. 

Treatment.  — During  the  early  stages  of  the  condition  cold 
applications  are  applied  either  in  the  form  of  cold  water  or 
ice  picks  which  should  be  carried  out  conscientiously  if  the 


384  DISEASES  OF  THE  ARTICULATIONS 

best  results  are  to  be  expected.  This  treatment  may  be 
followed  by  hot  applications  and  liniments  (soap  liniment, 
white  liniment,  iodin  liniment).  During  treatment  the 
animal  must  be  confined  to  ensure  rest  to  the  affected  joints. 
In  case  pus  is  present  in  the  articulation,  it  should  be  opened 
and  antiseptics  directly  injected.  (See  Wounds  of  Joints.) 
Chronic  cases  are  not  amenable  to  treatment. 


PART  VIII. 
DISEASES  OF  THE  URINARY  SYSTEM. 


CHAPTER  I. 
DISEASES  OF  THE  KIDNEYS. 

Examination.— Examination  of  the  kidneys  consists  of  ab- 
dominal palpation,  direct  inspection  and  exploration,  and 
examination  of  the  urine. 

(a)  Abdominal  palpation  is  best  done  with  the  animal  in  a 
standing  position,  using  the  fingers  of  both  hands.  By  gentle 
digital  pressure,  abnormalities  in  the  dimension  and  location 
of  the  kidneys  will  be  noted.  This  method  of  examination 
will  prove  satisfactory  only  in  cases  where  a  marked  enlarge- 
ment occurs,  or  in  emaciated  animals. 

(6)  Direct  inspection  of  the  kidneys  may  be  made,  espe- 
cially in  dogs,  by  performing  laparotomy  under  anesthesia 
(see  Laparotomy).  This  method  can  be  done  safely  and  will 
be  found  useful  in  determining  accurately  the  size,  consist- 
ency, and  location  of  the  kidneys.  In  cases  of  cysts  or  other 
enlargements  an  exploring  needle  may  be  used  to  obtain 
some  of  the  contents  for  examination. 

(c)  The  examination  of  the  urine  should  be  made  chemi- 
cally and  physically.  Chemically  tests  should  be  made  for 
albumin  and  sugar.  The  tests  for  albumin  are  made  as 
follows:  Heller's  ring  test  is  a  very  valuable  one  as  a  very 
small  percentage  of  albumin  can  be  demonstrated  with  it. 
It  is  made  in  the  following  manner:  A  small  amount  of 
urine  is  filtered,  poured  into  a  test-tube  containing  concen- 
trated nitric  acid.  At  the  point  of  contact  of  the  two  liquids 
25 


386  DISEASES  OF  THE  KIDNEYS 

a  well  defined  white  ring  forms,  the  depth  of  which  depends 
upon  the  amount  of  albumin  present. 

The  boiling  point  may  also  be  used.  Take  a  few  cubic 
centimeters  of  urine  in  a  test-tube  and  heat  to  boiling,  acidu- 
late by  adding  5  to  10  drops  of  concentrated  nitric  acid.  A 
precipitate  which  has  been  formed  by  earthy  phosphates  or 
carbonates  will  then  dissolve,  but  one  due  to  coagulated 
albumin  remains. 

The  metaphosphoric  acid  test  is  made  by  adding  an  aque- 
ous solution  of  metaphosphoric  acid  to  the  urine.  The  urine 
becomes  cloudy  in  case  albumin  is  present. 

The  acetic  acid-ferrocyanid  of  potassium  test  is  made  by 
adding  2  per  cent,  of  acetic  acid  to  the  urine  and  then  a 
5  per  cent,  solution  of  ferrocyanid  of  potassium,  the  latter 
drop  by  drop  avoiding  an  excess.  Jf  albumin  is  present  a 
decided  turbidity  or  flocculent  precipitate  appears. 

The  quantitative  determination  of  albumin  is  made  with 
Esbach's  albuminometer.  Acidulated  urine  is  filled  into  the 
sign  U,  the  reagent  up  to  R  (1  part  of  picric  acid,  2  parts  of 
citric  acid,  and  100  parts  distilled  water),  the  tube  is  closed 
with  a  rubber  stopper  and  slowly  turned  over  several  times 
without  shaking;  let  stand  at  room  temperature  for  twenty- 
four  hours,  the  precipitate  has  settled  and  may  be  read  off. 
The  figure  indicates  the  proportion  of  albumin  in  grams  pro 
mille.  Urine  containing  a  large  percentage  of  albumin  must 
be  first  diluted  with  water  and  the  indicated  figure  must  then 
be  multiplied  with  the  figure  of  the  dilution  to  obtain  the 
exact  amount  of  albumin  present. 

When  it  has  been  demonstrated  that  albumin  is  present 
in  the  urine,  then  it  must  be  determined  whether  the  albumin 
originates  from  the  kidneys,  from  the  urinary  passages,  or 
from  the  nearby  genital  organs.  If  the  urinary  sediment 
contains  no  organic  form  elements,  or  form  elements  derived 
from  the  kidneys,  and  if  the  presence  of  dissolved  coloring 
matter  of  the  blood  may  be  excluded,  then  it  is  positive  that 
it  is  renal  albuminuria.  If  there  is  a  large  amount  of  organic 
sediment  then  it  is  not  likely  to  be  renal  albuminuria.  In 
some  cases  it  is  possible  to  have  a  mixture,  coming  from  the 
kidneys  and  also  from  other  parts  of  the  urinary  system. 


CONGESTION  OF  THE  KIDNEYS— HYPEREMI A     387 

The  chemical  test  for  sugar  in  the  urine  is  best  made -by 
using  Trommer's  test,  which  is  as  follows: 

A  few  cubic  centimeters  of  urine  are  put  into  a  test-tube, 
after  removing  any  albumin  which  might  be  present,  dilute 
it  with  an  equal  volume  of  water,  render  it  alkaline  with  a 
small  quantity  of  sodium  hydrate,  then  add  drop  by  drop 
a  4  per  cent,  solution  of  copper  sulphate  until  the  liquid  is 
clear  and  the  sediment  dissolved,  then  heat  until  it  boils.  If 
sugar  is  present,  a  reddish-yellow  vapor  appears  at  the  sur- 
face of  the  fluid.  The  bismuth  test  is  often  used  for  the  same 
determination.  The  albumin  is  removed  from  10  parts  of 
urine  and  added  to  this  is  2  parts  of  subnitrate  of  bismuth, 
4  parts  Rochelle  salts,  and  100  parts  of  a  10  per  cent,  solution 
of  sodium  hydroxid.  This  mixture  is  boiled  for  five  minutes. 
It  becomes  black  if  sugar  is  present. 

To  determine  the  quantity  of  sugar  present  the  saccharom- 
eter  is  used.  The  urine  is  fermented  by  adding  a  small 
quantity  of  yeast.  Graduated  glass  tubes  or  other  appa- 
ratus are  necessary  to  determine  the  exact  quantity  of  sugar 
present. 

Physically  the  urine  varies  in  color  and  amount,  depending 
a  great  deal  upon  the  kind  and  amount  of  food,  the  condition 
of  the  kidneys,  and  the  species  of  the  animal. 


CONGESTION  OF  THE  KIDNEYS.     HYPEREMIA. 

This  condition  is-  divided  into  two  forms,  viz.:  (a)  Acute 
hyperemia  (arterial  hyperemia),  (6)  passive  hyperemia 
(venous  hyperemia) . 

Acute  Hyperemia.— Etiology.— The  causes  of  this  condi- 
tion are  usually  the  same  as  those  producing  acute  nephritis. 
Irritating  foodstuffs,  chemicals  and  various  diuretic  com- 
pounds, are  the  most  common  things  producing  acute  hyper- 
emia. It  may  occur  during  the  course  of  infectious  diseases 
(distemper,  rabies).  Plethoric  animals  frequently  have  active 
hyperemia  of  the  kidneys. 

Pathology.— The  kidneys  are  enlarged,  swollen,  softened 
and  highly  reddened.  The  arteries  and  capillaries  are  found 


388  DISEASES  OF  THE  KIDNEYS 

distended.  Small  hemorrhages  appear  under  the  capsule. 
The  capsule  is  easily  removed. 

Symptoms.— This  condition  may  not  produce  very  marked 
symptoms.  The  most  noticeable  is  the  increased  amount 
of  urine,  the  specific  gravity  of  which  is  much  lower  than 
normal.  Sensitiveness  over  the  region  of  the  kidneys,  and 
stiffness  in  walking  are  also  common  symptoms. 

Prognosis.— Depends  upon  the  cause.  There  is  always 
danger  of  the  condition  resulting  in  an  acute  inflammation 
of  the  kidneys. 

Treatment. — Acute  purgation  is  indicated.  Administration 
of  magnesium  sulphate,  or  calomel  to  remove  the  waste 
material  through  the  bowels.  Avoid  irritating  foodstuffs. 
Give  milk  for  a  few  days.  The  cause  should  be  removed  if 
possible. 

Passive  Hyperemia.— Etiology.— This  condition  is  brought 
about  as  a  secondary  disease  following  valvular  defects,  dis- 
eases of  the  lungs,  pleura,  etc.  In  some  cases  it  is  produced 
by  pressure  on  the  renal  vessels  by  tumors,  etc.  In  all 
instances  the  circulatory  disturbances  lead  to  an  engorgement 
or  passive  congestion  of  the  kidneys. 

Pathology.— In  passive  hyperemia  the  kidneys  are  of  a 
dark  bluish-red  color,  larger  than  normal.  On  cut  section 
the  venous  blood  oozes  out.  In  old  cases  there  will  be  found 
considerable  connective  tissue  thickening. 

Symptoms.— In  this  condition  the  quantity  of  urine  is 
decreased,  and  albuminuria  is  present. 

Prognosis.— Depends  upon  the  primary  condition. 

Treatment.  —Medical.— Digitalis  administered  in  small 
doses  daily.  Animals  should  be  given  gentle  exercise.  Give 
nourishing  food  which  is  non-irritating  (milk  and  eggs). 


INFLAMMATION  OF  THE  KIDNEYS.     NEPHRITIS. 

Acute  Nephritis — Definition. — An  acute  inflammatory  condi- 
tion of  the  kidneys,  which  is  characterized  either  by  nutritional 
disturbances  of  the  renal  epithelium  with  only  a  slight  change 
in  the  interstitial  connective  tissue  (parenchymatous  nephri- 


INFLAMMATION  OF  THE  KIDNEYS— NEPHRITIS  389 

tis),  or  an  involvement  of  both  the  renal  epithelium  and  the 
interstitial  tissue  without  the  formation  of  a  purulent  exudate 
(nephritis  acuta  diffusa). 

Etiology.— This  disease  is  quite  common  in  small  animals 
and  birds  in  which  it  frequently  develops  from  infectious 
diseases  and  poisons. 

Acute  nephritis  occurs  secondary  to  infectious  diseases. 
The  organisms  circulate  via  the  blood  stream,  become  lodged 
in  the  glomeruli  and  in  the  intertubular  bloodvessels,  and 
at  the  point  of  lodgment  injure  the  tissues.  In  this  way  the 
disease  occurs  during  the  course  of  distemper,  chicken  cholera, 
septicemia,  etc.  Bacterial  toxins  in  passing  through  the 
cellular  elements  of  the  kidneys,  produce  in  them  and  the 
bloodvessel  walls  certain  degenerative  processes,  which 
eventually  lead  to  an  acute  inflammation.  The  bacterial 
toxins  probably  produce  the  disease  in  the  majority  of  cases, 
as  the  absorption  of  toxins  takes  place  in  a  number  of  condi- 
tions, such  as  in  diseases  of  the  alimentary  tract,  diseases 
of  the  peritoneum,  etc.,  and  in  this  manner  we  may  account 
for  the  development  of  acute  nephritis  during  or  following 
such  diseases.  In  like  manner  acute  nephritis  may  occur 
following  any  organic  disease.  In  small  animals  it  frequently 
follows  the  ingestion  of  decayed  foods,  the  preformed  toxins 
are  absorbed  and  eliminated  through  the  kidneys,  producing 
a  severe  form  of  acute  nephritis.  The  same  condition  may 
result  from  absorption  of  products  from  wounds,  from  mange, 
eczema,  etc.,  especially  when  extensive. 

Acute  nephritis  also  develops  from  vegetable  and  mineral 
poisons,  especially  when  introduced  in  rather  large  quantities. 
Such  substances,  as  cantharides,  carbolic  acid,  arsenic,  oil 
of  turpentine,  extract  of  male  fern,  mercury  preparations, 
etc.,  are  eliminated  via  the  kidneys  and  excite  an  acute  inflam- 
mation. Birds  (turkeys)  often  eat  various  insects,  such  as 
grasshoppers,  caterpillars,  the  acrid  substances  of  which  are 
absorbed  from  the  intestinal  tract  and  induce  the  inflamma- 
tion. This  same  condition  has  been  observed  in  cats  from 
eating  large  numbers  of  insects  (grasshoppers). 

Injuries  in  small  animals  are  very  common,  such  as  blows 
across  the  back  in  the  region  of  the  kidneys,  being  run  over 


390  DISEASES  OF   THE  KIDNEYS 

by  vehicles,  falling,  etc.,  which  may  result  in  direct  injuries 
to  the  kidneys  and  eventually  in  acute  inflammation.  Sub- 
jection to  extreme  cold  has  been  considered  one  of  the  etio- 
logical  factors:  It  probably  reduces  the  general  resistance 
of  the  renal  tissue  so  that  infectious  substances  have  a  greater 
effect  upon  it.  This  has  been  observed,  especially  in  puppies 
and  kittens  that  have  been  kept  in  damp,  cold  kennels.  The 
same  thing  is  found  in  hunting  dogs  after  being  forced  to 
wade  or  swim  through  cold  water. 

Pathology.— This  is  usually  divided  into  three  classes  as 
follows : 

(a)  Parenchymatous  nephritis,  in  which  the  primary  inflam- 
matory changes  are  most  pronounced  in  the  parenchyma  of 
the  kidney.  This  is  characterized  by  only  slight  swelling, 
the  capsule  more  easily  removable,  and  on  cut  section  a 
grayish  or  dull  color  is  noted.  Sometimes  there  will  be 
observed  grayish-red  or  yellowish-brown  spots.  The  medul- 
lary substance  is  hyperemic,  often  dark  red  in  color  and  the 
Malpighian  bodies  are  quite  prominent,  while  the  balance 
of  the  organ  is  either  normal  or  of  a  soft  consistency. 

Microscopically  the  veins  and  capillaries  are  enlarged, 
congested,  granular  and  fibrous  deposits  between  the  urinif- 
erous  tubules,  and  epithelial  casts,  cells,  fatty  degeneration 
with  swelling  and  opacity. 

(6)  Hemorrhagic  parenchymatous  nephritis,  which  is  char- 
acterized by  a  large  number  of  red  points  giving  the  external 
appearance  of  the  organ  a  dark  red  color,  dull  gray  on 
section,  blotches  of  red  and  in  the  medullary  portion  a 
deep  red. 

Microscopically  the  veins  and  capillaries  are  found  engorged 
with  blood,  hemorrhages  appearing  in  the  adjacent  tissues. 

(c)  Diffuse  Acute  Nephritis.— Very  noticeable  is  the  in- 
crease in  size  and  weight  of  the  organ,  sometimes  two  or. 
three  times  larger  than  normal.  The  tissues  are  soft  and 
friable.  The  capsule  is  easily  removed,  and  the  external 
surface  a  bright  red  color  with  some  yellowish  or  gray  patches. 

Microscopically  there  will  be  found  enlargement  of  all 
vessels  with  extensive  extravasation  of  blood  into  the  tissues, 
leukocyte  casts  in  the  dilated  urinary  ducts,  and  extensive 


INFLAMMATION  OF  THE  KIDNEYS— NEPHRITIS     391 

cellular  infiltration  between  them.  The  glomeruli  are  often 
filled  with  blood  and  covered  with  bloody  extravasations. 

Symptoms.—  The  general  symptoms  are  loss  or  suppression 
of  the  appetite,  slight  elevation  of  the  body  temperature, 
pulse  strong  and  hard  at  first,  later  weak  and  rapid;  frequently 
vomiting  in  the  dog  and  cat.  Constipation  during  the  early 
stages,  followed  later  by  diarrhea,  is  prominent  in  most 
cases. 

Most  animals  have  difficulty  in  walking  (stiff  gait)  as 
the  movement  of  the  body  tends  to  compress  or  move  the 
kidneys,  hence  pain  is  induced.  During  the  early  stages  of 
the  disease  there  are  frequently  noticed  paroxysms  of  pain, 
especially  when  the  animal  is  first  moved,  or  palpated  over 
the  region  of  the  kidneys.  On  standing  they  assume  a 
stretched  attitude  in  order  to  relieve  the  tension  on  the  dis- 
eased organ.  Frequently  in  walking  the  limb  on  the  side 
affected  will  be  dragged  or  the  forward  step  shortened.  It 
has  been  observed  in  male  animals  that  one  testicle  will  be 
drawn  higher  than  the  other. 

The  changes  in  the  urine  form  the  most  characteristic 
symptom.  Usually  at  first  there  is  suppression,  with  very 
scanty  flow  of  urine,  highly  colored,  containing  some  blood, 
albumin  and  tube  casts.  The  total  quantity  passed  in  twenty- 
four  hours  is  greatly  reduced,  specific  gravity  high,  of  a 
thicker  consistency  than  normal,  often  slimy  and  turbid. 
Hematuria  may  develop. 

Microscopically  the  urine  is  found  to  contain  urinary  casts 
in  large  numbers,  white  and  red  blood  corpuscles  and  numer- 
ous epithelial  cells.  The  urine  is  voided  a  few  drops  at  a  time, 
especially  in  the  dog,  with  pain  (strangury) . 

Uremic  symptoms  are  noted  in  some  cases.  The  stoppage 
of  the  flow  of  urine  from  the  swelling  of  the  tissue  of  the 
kidneys,  compression  and  filling  of  the  ducts  with  exuded 
casts,  causes  a  retention  of  waste  products  and  a  lack  of 
secretion,  hence  an  accumulation  of  urea  and  uric  acid,  and 
other  decomposition  products  sufficient  to  produce  marked 
symptoms.  In  the  dog  these  symptoms  develop  rather 
rapidly  in  the  form  of  weakness,  staggering  gait,  convulsions, 
irregular  temperature  and  coma. 


392  DISEASES  OF  THE  KIDNEYS 

Diagnosis.  —This  condition  is  very  frequently  mistaken  for 
inflammation  of  some  other  abdominal  organ,  especially 
peritonitis,  enteritis,  cystitis,  or  metritis.  It  is  possible  to 
make  a  differential  diagnosis  by  a  careful  examination  of  the 
animal,  by  observing  the  character  and  amount  of  urine 
voided  and  a  microscopic  examination  of  the  urine. 

Course.— The  course  is  usually  acute;  occasionally  the  dis- 
ease terminates  in  chronic  nephritis. 

Prognosis.— On  the  whole. the  prognosis  is  unfavorable,  the 
patient  often  dying  in  six  to  ten  days.  When  the  symptoms 
of  uremia  are  present,  the  prognosis  should  be  considered 
very  unfavorable. 

Treatment.— Dietetic.—  For  the  dog  and  cat  a  milk  diet  is 
of  the  greatest  importance.  Avoid  the  giving  of  irritating 
foods  and  drugs. 

Medical.—  Establish  diaphoresis  as  early  as  possible.  This 
can  be  done  by  the  use  of  warm  baths,  steaming  the  animal, 
and  rubbing  the  skin.  Wrap  the  animal  in  warm  blankets. 
Diaphoretics,  such  as  pilocarpin,  are  not  very  satisfactory  in 
small  animals. 

Purgatives  are  to  be  recommended.  Magnesium  sulphate 
(10.0-16.0)  every  four  hours  until  active  catharsis  takes  place 
is  useful.  Small  doses  of  arecalin  (0.003-0.005)  may  be 
given  to  the  dog  to  hasten  early  evacuation  of  the  bowels. 

Calomel,  owing  to  its  prompt  action,  is  excellent  for  dogs. 
In  heart  weakness,  during  the  secondary  stages  of  the  dis- 
ease, digitalis  fluidextract  (0.1-0.15)  should  be  used.  Alka- 
line diuretics,  as  potassium  acetate,  are  to  be  used  in 
small  doses.  Diuretin  has  been  found  to  be  valuable  as  a 
diuretic. 

In  convulsions  following  uremia,  potassium  bromid  or 
morphin  for  dogs  should  be  administered.  Tannic  acid  (0.1) 
is  highly  recommended. 

Chronic  Nephritis — Definition.— A  chronic  inflammation  of 
kidney,  which  the  may  be  divided  clinically  into  two  groups, 
viz.: 

(a)  Chronic  parenchymatous  nephritis,  characterized  by 
marked  dropsy  and  during  the  early  stages  of  the  disease,  on 
postmortem,  by  the  large  white  kidney.  In  the  later  stages 


CHRONIC  NEPHRITIS  393 

of  the  disease  the  kidney  usually  is  small— small  white 
kidney. 

(6)  Chronic  interstitial  nephritis,  characterized  by  cardio- 
vascular changes  which  are  pronounced,  but  only  in  a  few 
instances  will  dropsical  conditions  appear. 

Etiology.  — It  has  been  observed  that  chronic  nephritis  in 
some  instances  follows  the  acute  form  of  the  disease.  This  is 
true  no  doubt  only  in  the  subacute  or  milder  acute  cases. 

It  may  develop  gradually  as  an  insidious  disease  without 
any  apparent  cause. 

Injurious  substances  in  the  form  of  irritants,  which  may 
be  either  parasitic  or  chemical  in  nature,  in  being  eliminated 
via  the  kidneys,  may  produce  sufficient  irritation  to  induce  a 
chronic  inflammation.  Certain  drugs  when  administered 
for  some  time  (turpentine)  or  absorbed  from  the  skin,  as  in 
the  treatment  of  mange  (coal-tar  compounds),  will  produce 
irritation  resulting  in  chronic  nephritis. 

It  may  follow  some  of  the  infectious  diseases,  such  as  dis- 
temper in  the  dog  and  cat.  The  excess  of  wraste  products 
together  with  the  various  toxins  formed  are  eliminated  in 
such  quantity  that  they  irritate  the  renal  tissue. 

Subjection  to  extremes  in  temperature  (cold  or  heat)  dis- 
turbs metabolism,  which  increases  the  action  of  the  kidneys, 
and  the  amount  of  albuminous  decomposition  may  be  a 
cause.  In  other  cases  no  apparent  cause  can  be  found. 

Pathology.  —  (a)  In  chronic  parenchymatous  nephritis  sev- 
eral varieties  have  been  recognized. 

The  large  white  kidney  is  characterized  by  enlargement, 
the  capsule  very  thin.  When  cut  longitudinally  the  cortex 
is  swollen  and  yellowish-white  in  color,  mottled  on  surface 
with  a  number  of  opaque  spots.  The  pyramids  of  the  kidney 
are  deeply  congested. 

The  small  white  kidney  in  which  the  connective  tissue  is 
found  thickened,  and  a  gradual  reduction  in  the  enlargement 
of  the  parenchymatous  tissue.  On  cut  surface  the  resistance 
is  much  greater  than  the  other  type,  the  cortex  is  much 
smaller  and  contains  a  number  of  white  or  whitish-yellow 
spots.  These  whitish-yellow  spots  represent  areas  of  fatty 
degeneration.  The  interstitial  tissue  is  changed,  enlarged, 


394  DISEASES  OF   THE  KIDNEYS 

many  of  the  glomeruli  destroyed,  degeneration  of  the  epi- 
thelium in  the  convoluted  tubules,  and  the  arteries  are  much 
thickened.  Microscopically  the  epithelium  is  found  granular 
and  fatty;  the  tubules  of  the  cortical  substances  are  enlarged 
and  filled  with  tube  casts.  Hyaline  changes  are  found  in  the 
epithelial  cells.  The  glomeruli  are  found  enlarged,  the  cap- 
sules are  thicker  than  normal,  and  the  capillaries  show  some 
hyaline  changes.  The  interstitial  tissue  is  increased  to  some 
extent. 

(6)  In  chronic  interstitial  nephritis  the  kidneys  are  small, 
contracted,  and  may  be  reduced  to  nearly  one-half  their 
normal  size.  The  capsule  of  the  kidney  is  thickened,  very 
much  adherent,  and  when  stripped  off  carries  with  it  some 
of  the  cortical  substance.  Small  cysts  are  often  found  on 
the  surface.  On  cut  section  the  kidney  is  found  reddish  or 
dark  red  in  color.  The  cortex  is  very  thin.  The  surface  of 
the  kidney  is  uneven  with  numerous  small  projections. 
Sometimes  the  kidneys  are  lobulated,  the  consistency  is  hard, 
and  the  general  texture  almost  semicartilaginous.  The  inter- 
stitial connective  tissue  is  far  in  excess  of  the  parenchy- 
matous  structure. 

Microscopically  there  is  noted  a  great  increase  in  the 
connective  tissue,  a  degeneration  and  atrophy  of  the  secreting 
structures,  both  glomerular  and  tubal..  The  increase  in  the 
fibrous  elements  is  widely  distributed  throughout  the  kidney, 
although  in  most  cases  found  more  extensively  in  the  cor- 
tical portion.  The  glomerular  changes  are  found  marked, 
numbers  of  them  being  completely  degenerated  into  hyaline 
substances.  The  tubules  show  changes  in  the  epithelium,  in 
some  instances  greatly  atrophied,  in  others  the  epithelium 
has  entirely  disappeared. 

The  bloodvessels  (arteries)  in  the  advanced  cases  show 
advanced  sclerosis.  The  changes  take  place  in  the  entire 
vessel  wall.  In  chronic  nephritis  we  find  in  a  great  many 
cases  in  dogs  organic  changes  in  the  heart  (hypertrophy). 

Symptoms.— This  condition  does  not  present  very  definite 
symptoms  until  the  disease  is  quite  well  advanced.  The  first 
symptoms  noted  are  those  of  a  general  nature,  such  as  par- 
tial or  complete  loss  of  appetite,  weakness,  fatigue,  etc. 


CHRONIC  NEPHRITIS  395 

In  parenchymatous  nephritis  the  secondary  symptoms 
are  characterized  by  dropsical  swellings  appearing  on  the 
limbs,  breast,  and  particularly  ascites.  The  animal  shows 
general  emaciation,  pale  membranes,  and  all  the  signs  of 
general  cachexia.  A  careful  examination  must  be  made  in 
such  cases  to  distinguish  from  circulatory  disturbances.  The 
urine  should  always  be  carefully  examined.  We  will  find 
in  these  cases  the  amount  of  urine  decreased  and  its  specific 
gravity  increased.  The  urine  will  also  be  found  to  contain 
numerous  casts,  epithelium,  fat  cells,  and  in  some  cases  red 
blood  corpuscles.  The  pulse  will  be  found  accelerated,  tense 
and  hard;  the  heart  beat  is  strong,  palpitating,  and  in  smaller 
breeds  may  shake  the  entire  body.  Marked  dulness  over  the 
region  of  the  heart  is  noted  indicating  hypertrophy.  The 
temperature  is  slightly  elevated  until  in  the  later  stages  of 
the  disease  when  it  will  be  found  to  be  subnormal.  In  the 
very  late  stages  symptoms  of  uremia  appear,  with  rapid 
emaciation  and  exhaustion,  and  the  animal  soon  succumbs. 

In  chronic  interstitial  nephritis  the  symptoms  are  some- 
what different.  The  most  noticeable  difference  is  in  the 
character  and  composition  of  the  urine.  The  amount  of 
urine  is  increased,  the  specific  gravity  very  low,  and  the 
albumin  content  is  greatly  diminished.  There  is  compensa- 
tory hypertrophy  of  the  heart,  and  if  this  compensating 
action  is  sufficient,  the  animal  may  live  for  some  time.  How- 
ever, sooner  or  later  there  will  be  insufficient  heart  action, 
the  pulse  will  become  weak,  feeble,  and  ascites  and  edemas 
appear.  The  animal  gradually  becomes  weaker  and  finally 
dies  from  exhaustion. 

Diagnosis. --This  is  only  possible  in  cases  where  a  careful 
examination  is  made  of  the  urine,  together  with  a  pains- 
taking general  examination.  We  must  differentiate  chronic 
nephritis  from  primary  circulatory  disturbances. 

Prognosis.  — In  both  forms  of  chronic  nephritis,  the  prog- 
nosis should  be  considered  unfavorable,  because  in  the 
majority  of  cases  the  condition  is  quite  well  advanced  before 
a  diagnosis  is  made.  Even  in  apparently  mild  cases  marked 
pathological  changes  in  the  kidneys  are  often  found. 


396  DISEASES  OF  THE  KIDNEYS 


Treatment.—  Dieted.—  Improve  the  general  condition  of 
the  animal  by  giving  plenty  of  milk  and  easily  digested  food. 
Avoid  highly  nitrogenous  foods. 

Medical.—  The  first  thing  to  be  considered  from  a  medical 
standpoint  is  to  sustain  and  strengthen  the  heart  action  by 
giving  small  doses  of  fluidextract  digitalis  (0.1  to  0.15)  daily. 
As  a  diuretic,  administer  diuretin  (0.2  to  0.4)  twice  daily. 
Calomel  is  useful  in  dogs  to  keep  the  bowels  open  and  assist 
in  the  elimination  of  waste  products. 

In  dropsical  conditions  (ascites)  small  doses  of  pilocarpin 
(dog  and  cat  0.003-0.01)  may  be  administered  once  daily. 
Small  doses  of  potassium  iodid  (0.06-0.2)  are  to  be  admin- 
istered as  a  resorbent  once  daily  to  dogs. 

Surgical.—  When  ascites  threatens  the  life  of  the  animal 
the  fluid  should  be  removed  with  a  trocar.  (See  Abdominal 
Puncture.) 

Purulent  Nephritis.—  Kidney  Abscess.—  Definition.—  An  in- 
flammation of  the  kidneys  resulting  from  infection  and 
characterized  by  the  formation  of  either  numerous  small 
purulent  foci,  or  larger  abscesses. 

Etiology.—  A  very  common  cause  of  this  condition  is  the 
infection  reaching  the  renal  tissue  from  the  blood  stream 
(hematogenous)  .  This  mode  of  infection  in  most  cases 
follows  diseases  of  other  organs,  or  pyemia,  such  as  endo- 
metritis  puerperalis  in  the  bitch  and  cat;  mammitis,  pneu- 
monia, phlegmonous  pharyngitis  in  the  cat;  purulent  bron- 
chial catarrh,  distemper,  and,  in  puppies,  infection  at  birth. 
It  has  been  found  that  purulent  nephritis  will  be  produced 
in  animals  without  any  particular  focus  of  infection.  In 
cases  of  general  reduced  resistance  the  organisms  may  find 
their  way  to  the  renal  tissue,  develop  and  form  abscesses. 

Traumatic  causes  are  quite  common  in  small  animals  as 
injuries  over  the  region  of  the  kidneys  are  frequent.  These 
may  bring  about  the  condition  by  reducing  the  local  resist- 
ance and  the  accompanying  inflammation  makes  a  favorable 
place  for  the  development  of  organisms  which  are  present 
in  the  blood  stream. 

Urogenic   causes   are  perhaps   the   most  frequent.     The 


PURULENT  NEPHRITIS  397 

infection  spreads  to  the  organ  via  the  bladder,  ureters,  and 
pelvis  of  the  kidney. 

In  small  animals  subjection  to  extremes  in  temperature 
has  been  mentioned  as  an  indirect  factor  in  bringing  about 
the  condition, 

Pathology. — We  recognize  two  forms  of  purulent  nephritis 
on  postmortem: 

Diffuse  Purulent  Nephritis  (Nephritis  purulenta  punctata, 
diffusa).~\n  this  form  the  kidneys  are  enlarged;  numerous 
small  white  spots  or  yellowish  dots  are  present  which  are  sur- 
rounded by  a  reddish  zone.  On  close  examination  the  puru- 
lent masses  may  be  easily  removed.  These  foci  of  infection 
may  be  found  quite  generally  distributed  in  one  or  both 
kidneys. 

Microscopically  there  is  found  a  large  number  of  pus  cells 
in  the  foci  of  infection,  cellular  infiltration  with  large  numbers 
of  bacteria  present  in  the  tissue  surrounding  them.  The 
epithelial  cells  show  fatty  degeneration,  the  glomeruli 
surrounded  by  pus,  and  the  tubules  partially  filled  with 
leukocytes,  red  blood  cells,  and  casts. 

Nephritis  Apostematosa  (Renal  abscess).— We  find  in  this 
form  abscesses  of  varying  size,  which  may  be  a  single  abscess 
formed  from  an  embolus,  or  the  kidney  tissue  break  down  to 
form  a  very  large  abscess  (pyonephrosis).  The  connective 
tissue  increases  around  the  abscess  forming  a  thick  wall. 

Symptoms.— Clinically  it  is  quite  difficult  to  recognize  this 
condition.  In  cases  which  originate  by  metastasis  we  will 
observe  the  symptoms  of  the  primary  condition,  such  as 
pyemia,  endometritis,  etc. 

Should  the  disorder  develop  rapidly,  there  will  be  found 
practically  the  same  symptoms  as  in  acute  diffuse  nephritis. 
(See  Acute  Nephritis.) 

In  dogs  the  patient  becomes  very  stiff,  refuses  to  move, 
shows  pain  on  palpation  over  the  region  of  the  kidneys;  in 
some  cases  a  distinct  enlargement  on  one  or  both  sides  high 
in  the  lumbar  region  can  be  determined.  In  examining  such 
cases  the  animal  should  be  placed  in  a  standing  position, 
both  hands  used,  one  on  either  side  of  the  animal,  and  the 


398  DISEASES  OF   THE  KIDNEYS 

palpation  performed  with  gentle  pressure.  Micturition  is 
painful,  very  often  only  small  quantities  of  urine  being  voided. 
As  the  disease  progresses  more  pronounced  general  symptoms 
of  weakness,  exhaustion,  and  uremia  will  be  observed. 
Animals  often  die  very  early  from  general  sepsis. 

Diagnosis.— An  accurate  diagnosis  is  very  difficult.  In 
many  cases  the  disease  is  not  recognized  until  a  postmortem 
examination  is  made.  The  symptoms,  including  careful 
palpation  coupled  with  examination  of  the  urine,  usually 
suffice  for  the  diagnosis. 

Prognosis.— The  prognosis  is  bad  as  the  disease  is  usually 
in  an  advanced  stage  before  being  recognized. 

Treatment.— In  cases  of  advanced  renal  abscess  there  is 
little  that  can  be  done.  The  operation  of  removing  one 
kidney  does  little  good  as  both  are  usually  diseased.  Uremia 
commonly  follows  the  removal  of  the  kidney  when  both  are 
involved.  Symptomatic  treatment  is  about  all  that  can  be 
done.  Heart  stimulants,  laxatives,  etc.,  may  be  tried.  (See 
Acute  Nephritis.) 

INFLAMMATION  OF  THE  RENAL  PELVIS. 

Pyelitis. 

Definition.— Inflammation  of  the  pelvis  of  the  kidney. 

Etiology.— Pyelitis  may  result  from  the  spread  of  inflamma- 
tion from  adjacent  parts  or  organs,  such  as  from  the  kidney 
(pyelonephritis)  or  from  the  bladder  (pyelocystitis). 

The  presence  of  urinary  calculi  in  the  pelvis  of  the  kidney 
mechanically  irritates  the  membrane  and  leads  to  an  inflam- 
mation. 

In  the  course  of  infectious  diseases  (distemper  in  the  dog 
and  cat;  cholera  in  birds)  this  condition  develops  on  account 
of  the  infectious  or  poisonous  matter  excreted  from  the  body 
via  the  kidneys  irritating  the  mucous  membrane. 

Excretion  of  toxic  materials  (poisons  of  different  kinds) 
would  act  in  a  similar  manner.  On  account  of  the  frequency 
of  poisoning  in  small  animals  this  is  a  very  common  cause. 

Parasites  often  cause  pyelitis,  especially  in  dogs 
(Dioctophyme  renale).  The  parasites  cause  an  intense  inflam- 


INFLAMMATION  OF  THE  RENAL  PELVIS         399 

mation  of  the  pelvis  of  the  kidney  which  may  involve  the 
entire  organ. 

Retention  of  urine  from  either  disease  of  the  ureters  or 
the  bladder.  This  leads  to  an  inflammation  of  the  pelvis  of 
the  kidney  from  decomposition  of  the  urine. 

Pathology.— Catarrhal  inflammation  of  the  pelvis  of  the 
kidney  is  characterized  by  swelling  and  redness,  some  hem- 
orrhage, and  later,  as  the  condition  becomes  chronic,  the 
membrane  becomes  thickened,  lighter  in  color  and  covered 
with  thick  mucus  or  pus.  In  severe  cases  numerous  hemor- 
rhagic  foci  will  be  observed,  with  sometimes  extensive  hemor- 
rhage, or,  if  the  irritation  has  been  severe,  ulcers  will  be 
found  (pyeloulcerosa).  In  cases  which  have  resulted  from 
obstruction  to  the  flow  of  urine,  we  may  find  dilatation  of 
the  pelvis  of  the  kidneys,  with  the  presence  of  urine  (hydro- 
nephrosis). 

Symptoms.— This  disease  does  not  present  a  clear  clinical 
picture;  it  can  easily  be  confused  with  inflammation  of  the 
kidneys  or  adjacent  parts.  The  general  symptoms  are  a 
disturbed  general  condition  of  the  animal,  frequent  micturi- 
tion, which  is  more  or  less  painful,  stiff,  painful  gait,  loss  of 
appetite  and  slight  elevation  of  temperature.  The  urine 
shows  changes  which  should  be  considered.  It  will  be  found 
to  contain  much  mucus,  pus,  organic  sediment,  long-tailed 
epithelial  cells,  having  pointed  projections  on  the  ends, 
which  come  from  the  membrane  of  the  renal  pelvis.  The 
urine  should  be  examined  for  parasite  eggs;  this  will  often 
assist  in  locating  the  seat  of  the  inflammation.  Small  granules 
are  found  when  calculi  are  present.  Careful  palpation  as  in 
chronic  nephritis  may  assist  in  locating  the  inflammation. 

Diagnosis.— The  microscopic  examination  of  the  urine  is 
the  best  means  of  making  an  accurate  diagnosis.  The  pres- 
ence of  the  peculiar,  molar-shaped  epithelial  cells  may  be 
considered  significant.  Pyelitis  must  be  differentiated  from 
inflammation  of  the  mucous  membrane  of  the  bladder  or 
ureters.  The  presence  of  parasite  eggs  (Dfoctophyme  renale) 
in  the  urine  will  be  indicative  of  involvement  of  the  renal 
pelvis. 

Prognosis.  — The  prognosis  depends  to  some  extent  upon  the 
causative  factor.  In  most  cases  it  is  not  very  favorable. 


400  DISEASES, OF   THE  KIDNEYS 

Treatment.— Dietetic.— Milk  should  be  the  principal  food. 
No  irritating  materials  should  be  given. 

Medical.— Diluents  in  the  form  of  water  or  milk  should 
be  administered  frequently  (2  or  3  times  daily)  to  assist  in 
increasing  the  volume  of  fluids  eliminated  via  kidneys  to 
remove  accumulated  products. 

Disinfectants  in  the  form  of  sodium  salicylate  (dog,  0.1- 
2.0;  cat,  0.05-0.1)  should  be  given  twice  daily.  Urotropin 
(0.5-1.0)  three  times  daily  with  plenty  of  water  or  milk  is 
useful. 

UREMIA. 

Definition. — A  toxemia  developing  during  the  course  of 
certain  diseases,  such  as  nephritis  or  in  conditions  associated 
with  retention  of  the  urine.  The  nature  of  the  poisons 
retained  in  the  body  is  not  definitely  known.  They  may 
be  normal  urine  compounds,  or  the  result  of  abnormal 
metabolism. 

Etiology.  —  Uremia  is  produced  by  the  retention  in  the  body 
of  waste  materials  which  should  be  eliminated  by  the  kidneys. 
In  the  development  of  certain  diseases,  such  as  acute  and 
chronic  nephritis,  or  obstruction  to  some  part  of  the  urinary 
passages,  the  urine  is  not  properly  excreted  but  is  retained 
in  the  blood.  If  due  to  stoppage  of  the  outflow,  the  back 
pressure  produced  inhibits  further  secretion,  hence  the 
products  of  metabolism  accumulate  in  the  body. 

A  cause  is  rupture  of  some  of  the  urinary  organs  (kidneys, 
ureter  or  bladder)  which  is  of  frequent  occurrence  in  the  dog 
from  injuries.  The  urine  will  flow  out  into  the  adjacent 
tissues,  or  peritoneal  cavity,  to  be  absorbed  by  the  circula- 
tion, producing  in  the  course  of  a  few  hours  marked  symptoms 
of  acute  poisoning. 

Symptoms.— Clinically  we  recognize  two  forms:  (a)  Acute 
uremia,  and  (6)  chronic  uremia. 

Acute  Uremia.— In  the  dog  the  symptoms  usually  begin 
with  chills,  trembling  of  the  muscles,  staggering  gait,  followed 
in  a  short  time  by  stupor,  the  animal  finally  lapsing  into 
complete  unconsciousness.  Frequently  there  will  be  noted 


UREMIA  401 

during  the  development  of  uremia  certain  nervous  symptoms, 
such  as  contractions  of  groups  of  muscles  (clonic  spasms, 
epileptiform  convulsions)  followed  by  unconsciousness. 
Yelping  or  howling  is  often  a  prominent  symptom  during 
the  nervous  attacks. 

The  respirations  are  slow,  often  difficult;  edema  of  the 
lungs  usually  exists. 

The  temperature  is  at  first  elevated,  but  later  becomes 
subnormal,  sometimes  as  low  as  96°  F. 

Vomiting  in  the  dog  and  cat  is  a  frequent  symptom  as 
is  diarrhea.  The  discharges  from  the  stomach  and  bowels 
usually  have  a  uriniferous  odor. 

Chronic  Uremia.— Chronic  uremia  develops  from  chronic 
diseases  of  the  urinary  organs,  particularly  chronic  nephritis, 
and  from  long  standing  cases  of  partial  urine  retention  due 
to  some  obstruction  in  the  urinary  tract. 

The  most  prominent  symptoms  of  chronic  uremia  are: 
Digestive  disturbances,  such  as  gastro-intestinal  catarrh, 
diarrhea,  vomiting,  etc.,  without  any  apparent  cause;  dis- 
turbances in  the  nervous  system  as  dulness,  and  at  times  epi- 
leptiform convulsions,  which  are  usually  mild  and  recurrent. 

Diagnosis.— This  is  made  by  careful  examination  of  the 
patient,  observation  of  the  symptoms,  and  examination  of 
the  urinary  organs. 

Prognosis.— The  prognosis  depends  upon  the  primary  con- 
dition producing  the  uremia.  In  acute  uremia  it  is  unfavor- 
able, most  cases  terminating  fatally. 

Chronic  uremia  is  not  so  immediately  fatal.  The  long 
course  of  the  disease,  which  suffers  exacerbations  and  remis- 
sions, eventually,  however,  terminates  in  death. 

Treatment.— Medical.— Medical  treatment  consists  in  the 
administration  of  laxatives  to  assist  the  elimination  of  urea 
compounds  via  the  bowels.  Diuretics  are  used  except  in 
those  cases  where  there  is  some  impediment  to  the  outflow 
of  urine. 

In  chronic  cases,  after  the  uremic  symptoms  begin  to  dis- 
appear, tonics  and  alteratives  are  indicated. 

Surgical.— Where  an  obstruction  exists  in  some  portion 
of  the  urinary  tract,  which  interferes  with  the  outflow  of 

26 


402  DISEASES  OF  THE   KIDNEYS 

urine  an  operation  may  be  indicated.  Rupture  of  the  bladder 
or  ureters  should  receive  immediate  attention  and  the  torn 
or  injured  part  sutured. 

CALCULI  IN  THE  KIDNEY. 

Nephrolithiasis. 

Definition.— The  presence  of  urinary  stones  in  the  pelvis 
of  the  kidney. 

Etiology.— Calculi  in  the  renal  pelvis  are  not  frequent  in 
small  animals.  They  are  far  more  common  in  the  bladder. 
The  principal  condition  for  the  formation  of  urolithic  deposits 
is  that  the  urine  contains  excess  of  salts,  or  that  insoluble -or 
slightly  soluble  salts  are  formed  in  it.  In  the  elimination 
of  these  salts  they  become  gradually  deposited  around  some 
foreign  material.  The  center  or  nucleus  of  a  calculus  is 
usually  an  epithelial  cell,  bit  of  mucus,  pus,  a  blood  cell,  cast, 
etc.  In  some  cases  the  food  which  is  rich  in  salts  of  various 
kinds  will  hasten  the  formation  of  calculi.  In  certain  dis- 
tricts where  the  water  is  rich  in  mineral  substances  calculi 
are  more  common,  no  doubt  due  to  the  excess  salts  taken 
in  and  eliminated.  Inflammatory  diseases  of  the  urinary 
passages,  or  in  retention  of  urine  from  any  cause,  will  often 
lead  to  the  formation  of  urinary  calculi  by  changing  the 
character  of  the  urine  and  the  salts  contained  therein. 

Pathology.— Stones  in  the  pelvis  of  the  kidney,  if  small, 
may  not  produce  much  change  in  the  mucosa,  except  slight 
abrasion  and  irritation.  When  larger  they  may  fill  up  the 
entire  calices  or  the  whole  renal  pelvis,  and  can  lead  to  marked 
pathological  changes  such  as  extensive  inflammation,  hemor- 
rhage, and  sometimes  marked  distention  of  the  pelvis.  In 
small  animals  the  calculi  usually  consist  of  ammoniacal 
magnesium  phosphate,  small  quantities  of  calcium  phosphate 
or  carbonate,  some  uric  acid  and  its  salts.  Cystic  calculi  are 
also  occasionally  seen.  They  are  small,  soft,  and  have  a 
shiny  surface. 

Symptoms.— The  clinical  picture  of  kidney  stones  is  very 
similar  to  that  of  pyelitis,  except  the  pain  is  usually  more 


CALCULI  IN   THE  KIDNEY  403 

severe.  The  condition  may  be  entirely  overlooked  during 
the  life  of  the  patient.  The  most  pronounced  symptoms  are 
sudden  attacks  of  colic,  which  come  on  after  running,  jump- 
ing, or  falling,  which  dislodge  the  stone  and  occlude  the 
ureter.  The  colicky  symptoms  are  howling,  whining  and 
crying,  which  continue  until  the  stone  either  passes  into  the 
bladder  or  back  into  the  pelvis  of  the  kidney.  A  prolonga- 
tion of  the  retention  of  urine  may  result  in  uremic  symptoms. 
Periodic  recurrence  of  the  colicky  pains  is  somewhat  charac- 
teristic of  this  condition.  The  urine  when  examined  micro- 
scopically will  be  found  to  contain  pus  cells,  epithelial  cells, 
and  often  very  small  fragments  of  stones.  Blood  cells  are 
also  common  as  small  hemorrhages  frequently  take  place. 
In  the  dog  a  direct  examination  can  be  made  by  performing 
a  laparotomy  which  permits  of  the  kidney  being  seen  and 
felt.  If  calculi  are  present,  they  will  be  easily  recognized  by 
their  hardness  and  shape. 

Diagnosis. — The  general  symptoms  are  not  sufficient  for 
an  accurate  diagnosis.  It  should  be  differentiated  from  other 
diseases  of  the  kidney.  The  urine  should  be  carefully  exam- 
ined. In  doubtful  cases  a  laparotomy  may  be  performed. 

Prognosis.— The  prognosis  depends  on  the  size  and  number 
of  stones  present  and  whether  or  not  the  condition  is  uni-  or 
bilateral.  When  the  stones  are  small  and  the  condition  con- 
fined to  one  kidney,  the  prognosis  is  much  more  favorable. 
Owing  to  the  difficulties  encountered  in  removing  the  stones 
the  prognosis  is  usually  unfavorable. 

Treatment.— Dietetic.— Food  should  be  given  that  contains 
but  a  small  quantity  of  salts.  Plenty  of  water  should  be 
allowed  but  the  same  precaution  must  be  observed  in  regard 
to  the  salt  content. 

Medical.— The  various  compounds  used  to  dissolve  calculi 
have  not  proved  very  satisfactory.  Large  quantities  of 
carbonated  water  may  be  tried;  it  has  proved  of  value  in 
some  cases. 

Surgical.  —  Surgical  treatment  has  proved  of  practical 
importance  in  the  dog,  and  has  been  successfully  accom- 
plished in  a  number  of  cases.  If,  after  an  explorative  lapa- 
rotomy of  the  kidney,  it  is  found  normal,  showing  no  evidence 


404  DISEASES  OF  THE  KIDNEYS 

of  hydronephrosis,  nephrolithotomy  should  be  performed. 
There  are  two  methods  used  in  this  operation,  as  follows: 

(a)  A  longitudinal  incision  is  made  at  the  convex  border 
of  the  kidney,  at  which  point  the  vascularity  is  at  a  minimum, 
into  the  pelvis.  In  case  hemorrhage  is  severe,  clamping  the 
renal  artery  will  control  it.  By  compressing  the  kidney 
longitudinally  the  incision  will  be  held  open  and  with  a 
blunt  curette  the  stones  are  removed.  Care  should  be  taken 
to  be  sure  that  the  renal  pelvis  is  freed  of  all  the  calculi, 
and  a  blunt  probe  of  small  caliber  inserted  into  the  ureter  to 
be  certain  of  a  free  passage  into  the  bladder.  Normal  salt 
solution,  which  has  been  previously  sterilized,  is  used  to 
cleanse  the  cut  surface.  The  wound  is  then  stitched  with 
sterile  silk,  using  two  or  three  interrupted  sutures.  Care 
must  be  taken  not  to  use  too  much  force  in  drawing  the  wound 
together  as  the  resulting  swelling  will  tear  out  the  sutures. 
Return  the  organ  to  its  proper  position.  Healing  should  take 
place  per  primam. 

(6)  The  other  method  is  to  open  the  pelvis  of  the  kidney 
direct.  Make  an  incision  at  one  side  of  the  pelvis,  in  about 
its  middle  portion,  of  sufficient  size  to  remove  the  calculi. 
After  all  the  stones  have  been  removed  and  all  the  fluids 
absorbed  by  sterile  gauze,  the  wound  is  stitched  carefully, 
using  plenty  of  sutures  so  that  the  edges  of  the  wound  will 
be  thoroughly  approximated.  This  must  be  done  carefully 
to  avoid  fistula  following  the  operation.  If,  however,  the 
kidney  is  found  diseased  (hydronephrosis)  nephrectomy 
should  be  performed,  as  follows:  Laparotomy  is  performed. 
The  kidney  is  then  freed  of  its  covering,  gently  pulled  toward 
the  wound,  and  doubly  ligated  at  its  pedicle,  so  as  to  prevent 
serious  hemorrhage.  Care  should  be  taken  to  get  the  ligature 
securely  in  place  to  prevent  its  slipping  off  after  the  abdom- 
inal wound  is  closed.  Double  ligation  is  safest,  ligating  the 
vein  and  artery  separately. 

After-treatment  consists  in  the  administration  of  general 
stimulants,  and  restricting  the  diet  for  four  or  five  days  to 
milk,  or  milk  and  eggs. 


DROPSY  OF  THE  KIDNEY  405 

DROPSY  OF  THE  KIDNEY. 

Hydronephrosis.     Cystic  Kidney. 

Definition.— A  chronic  condition  in  which  urine  collects  in 
the  pelvis  of  the  kidney  or  the  kidney  proper,  leading  to 
functional  disturbances  of  the  organ. 

Etiology.— (a)  Mechanically  by  some  impediment  to  the 
flow  of  urine  from  one  or  both  kidneys.  The  urine  is  dammed 
up  in  the  pelvis  of  the  kidney  with  a  gradually  increasing 
pressure.  As  the  pressure  of  the  urine  increases,  the  loss  in 
the  secreting  power  of  the  organ  is  more  manifest,  and  event- 
ually if  the  pressure  is  constant  or  increased,  the  function 
of  the  organ  may  be  entirely  lost.  The  parts  of  the  urinary 
passages  affected  by  the  impediment  gradually  dilate '  and 
the  renal  tissue  atrophies,  so  that  the  condition  anatomically 
stops  as  no  more  urine  is  secreted. 

(6)  A  number  of  conditions  which  cause  partial  stoppage  of 
the  flow  of  urine  will  cause  cystic  kidney.  The  most  frequent 
are:  Catarrhal  inflammation  of  the  ureters,  bladder,  or 
prostate  glands;  the  presence  of  calculi  in  some  portion  of  the 
tract  which  interferes  with  the  passage  of  urine. 

(c)  Sometimes  the  condition  is  congenital;  there  is  either 
no  opening  through  the  ureter,  or  it  is  otherwise'  anatomi- 
cally deficient.    This  allows  the  urine  first  formed  to  accu- 
mulate until  the  backward  pressure  is  sufficient  to  stop  renal 
secretion. 

(d)  Compression  of  the  urethra  and  neck  of  the  bladder 
by  adjacent  new  growths.    The  new  growths  interfere  with 
the  flow  of  urine  and  cause  it  to  accumulate  in  the  pelvis  of 
the  kidney. 

(e)  Paralysis  of  the  urinary  bladder  which   allows  the 
urine  to  collect  and  lead  to  back  pressure. 

(/)  In  chronic  inflammation  of  the  kidneys  some  of  the 
urinary  tubules  become  constricted  at  certain  points  by  the 
contraction  of  the  interstitial  tissue,  which  undergoes  atrophy, 
causing  the  canals  which  are  attached  to  the  Malpighian 
bodies  to  become  dilated.  If  the  urine  continues  to  be 
secreted  it  accumulates  and  forms  small  retention  cysts. 
These  cysts  may  be  found  singly  or  in  large  numbers  in  the 


406  DISEASES  OF  THE  KIDNEYS 

kidneys.  This  type  of  the  condition  is  not  found  as  often  as 
the  other  form. 

Pathology.  —  We  find  varying  degrees  of  cystic  kidney.  In 
the  earlier  cases  will  be  noted  only  a  dilation  of  the  calices 
and  pelvis  of  the  kidney  with  mild  pathological  changes  in 
the  lining  membrane.  In  the  more  advanced  cases  will  be 
noted  distention  of  the  pelvis  of  the  kidney  with  compression 
of  the  renal  tissue  so  that  the  atrophy  is  well  marked.  In 
some  cases  the  renal  tissue  will  be  practically  destroyed,  and 
the  kidney  will  be  represented  by  a  soft  undulating  mass.  In 
dogs  the  kidneys  may  be  so  enlarged  that  distention  of  the 
abdominal  wall  appears. 

Symptoms.—  Frequently  on  autopsy  cystic  kidney  involv- 
ing one  of  the  kidneys,  will  be  found  which  has  not  been 
noticed  during  the  life  of  the  animal,  the  other  kidney  having 
performed  the  function  of  both.  When  both  kidneys  are 
involved,  howe\er,  a  change  in  the  quantity  of  urine  will  be 
noticeable.  On  careful  examination  of  the  patient  (dog) 
very  frequently  one  of  the  kidneys,  or  in  rare  cases  both  of 
them,  will  be  found  much  enlarged  and  can  be  easily  palpated 
through  the  abdominal  wall;  cases  appearing  where  the 
abdominal  enlargement  is  noticeable  by  observing  the  stand- 
ing patient  from  the  rear  and  carefully  comparing  both  sides. 
General  symptoms  of  weakness,  stiffness,  etc.,  are  shown  in 
the  more  advanced  cases.  Generally,  however,  cystic  kidney 
does  not  produce  characteristic  symptoms  during  life. 

Diagnosis.— This  is  made  by  careful  examination  of  the 
patient,  observing  the  flow  of  urine,  and  finally  where  neces- 
sary an  explorative  laparotomy. 

Prognosis.— Favorable  when  unilateral  as  it  may  not  affect 
the  general  health  of  the  patient;  unfavorable  when  bilateral. 

Treatment.— The  early  indication  in  the  treatment  is  to 
relieve  the  impediment  to  the  flow  of  urine.  The  ureters, 
bladder,  and  urethra  should  be  examined  and  if  diseased 
proper  treatment  should  be  given.  If  the  outflow  of  urine 
can  be  reestablished,  the  disorder  will  be  relieved.  If  this 
is  impossible,  nephrectomy  should  be  performed  if  the  con- 
dition is  unilateral.  (For  Nephrectomy,  see  Renal  Calculi.) 
No  other  treatment  has  been  found  of  value. 


ANIMAL  PARASITES  IN   THE  KIDNEY  407 

AMYLOID  KIDNEY. 

This  condition  is  of  no  practical  importance  except  to  the 
student  in  pathology.  It  is  not  common  in  the  small  animals 
and  the  symptoms  are  very  obscure. 

TUMORS  IN  THE  KIDNEY. 

In  small  animals  the  kidneys  are  not  commonly  affected 
by  primary  tumor  formations.  There  will  be  found:  Sar- 
comata, carcinomata,  and  adenomata,  occasionally  resulting 
as  secondary  growths  from  some  other  organ  or  tissues. 
Tuberculosis  of  the  kidney  has  been  noted  in  a  few  cases  in 
the  dog.  It  may  be  either  metastatic  or  urogenic  in  origin. 

It  is  not  usually  possible  to  recognize  tumors  during  life. 
They  sometimes  produce  disturbance  in  kidney  function 
and  may  become  metastatic. 

Treatment. — Treatment  must  be  symptomatic. 

ANIMAL  PARASITES  IN  THE  KIDNEY. 

Dioctophyme  renale  (Eustrongylus  GV</as).— This  is  the 
most  common  parasite  found  in  the  kidney  of  small  animals 
where  it  is  confined  almost  exclusively  to  the  dog.  Its  loca- 
tion is  usually  in  the  pelvis  of  the  kidney  where  in  some  cases 
it  produces  marked  clinical  symptoms;  in  others  but  little 
disturbance  results  considering  the  degree  of  pathological 
change  induced. 

Dioctophyme  renale  is  a  blood-red  worm  with  a  number 
of  fine  transverse  stripes,  tapering  slightly  at  the  extremities. 
The  mouth  is  triangular  in  shape,  and  surrounded  by  six 
small  papilla'.  The  male  is  13  cm.  to  40  cm.  long,  and  4  mm. 
to  0  mm.  in  diameter;  tail  is  obtuse,  terminated  by  a  patelli- 
form,  membranous,  entire  pouch  without  radia%  and  traversed 
by  a  very  slender,  single  spicule.  Female,  20  cm.  to  1  m. 
long,  and  5  mm.  to  12  mm.  in  diameter;  tail  is  obtuse  and 
slightly  curved;  a  single  ovary;  vulva  very  near  the  mouth. 
Ova  ovoid  and  brownish,  OS  to  80  microns  long,  and  40  to  43 
microns  broad.  (Neuman.) 


408  DISEASES  OF  THE  KIDNEYS 

The  life  cycle  of  the  Dioctophyme  renale  is  not  entirely 
known.  The  ovum  is  expelled  from  the  body  of  the  host, 
and  undergoes  further  development  in  water  or  damp  soil. 
It  requires  some  time  for  these  changes  to  take  place  (from 
three  to  six  months).  The  embryo  may  live  and  be  active 
after  one  year  to  eighteen  months.  The  embryo  is  240 
microns  long  and  14  microns  broad,  cylindrical,  and  gradually 
tapering  posteriorly;  the  head  is  pointed,  mouth  terminal 
and  not  provided  with  papillae,  but  with  a  small  projection 
which  no  doubt  serves  the  embryo  as  an  organ  of  penetration. 
The  intermediate  host  has  not  been  fully  determined.  The 
dog  takes  the  embryo  into  the  intestinal  tract,  where  it 
undergoes  further  development,  and  the  embryo  migrates  to 
the  organs  and  tissues.  It  may  also  be  introduced  into  the 
urinary  passages  direct.  The  favorite  seat  is  the  kidney, 
although  it  may  be  found  in  the  abdominal  cavity,  liver,  etc. 
There  still  exists  some  doubt  as  to  the  exact  method  of  migra- 
tion of  the  embryo. 

The  parasite  after  reaching  its  destination,  develops  and 
produces  marked  changes  in  the  pelvis  of  the  kidney,  and  in 
a  number  of  instances  completely  destroys  the  organ.  In 
cases  of  early  invasion  there  will  be  found  inflammation  with 
hemorrhages,  and  purulent  material.  More  advanced  cases 
will  reveal  a  secondary  inflammation  with  destruction  of  the 
renal  tissue,  often  transforming  the  kidney  into  a  sac  with 
thick  walls.  The  worm  or  worms  will  be  found  coiled  up  in 
this  sac.  The  number  of  parasites  found  will  vary.  In 
most  cases  only  one;  in  others  two  or  more,  even  as  high  as 
four  have  been  found. 

Symptoms.— There  may  be  no  symptoms  during  life.  In 
a  case  of  the  author's  in  which  four  parasites  were  found,  and 
the  renal  tissue  completely  destroyed,  the  dog  showed  no 
symptoms.  The  worms  were  found  on  autopsy.  The  animal 
was  in  excellent  condition  and  apparently  in  the  best  of 
health.  However,  in  some  cases,  symptoms  are  observed. 
Severe  pain,  restlessness,  nervousness  and  even  rabiform 
phenomena  have  been  observed.  The  dog  may  show  spinal 
curvature  due  to  pain  on  the  affected  side.  The  general 
condition  is  often  interfered  with,  the  animal  becoming 


ANIMAL  PARASITES  IN  THE  KIDNEY  409 

emaciated  and  exhausted.  The  urine  is  voided  with  difficulty, 
containing  blood  and  pus.  Examined  microscopically  it 
will  reveal  a  pyelitis,  and  the  eggs  of  the  parasite.  In  some 
instances  after  the  renal  tissue  is  completely  destroyed,  the 
parasite  will  pass  into  the  urethra  where  it  becomes  lodged. 
It  may  burrow  through  the  urethral  wall  and  ultimately 
lodge  in  either  the  pelvic  fascia  or  work  forward  into  the 
abdominal  cavity.  Eventually  it  will  produce  inflammation 
in  the  new  location,  resulting  in  abscess,  perforation  and 
external  fistula.  Peritonitis  may  result  following  its  entrance 
into  the  abdominal  cavity. 

Diagnosis.— An  accurate  diagnosis  can  be  made  only  by 
finding  the  eggs  in  the  urine  by  microscopic  examination. 
The  symptoms  would  be  much  the  same  as  those  in  pyelitis, 
etc. 

Prognosis. — \\hen  the  parasite  has  produced  sufficient 
pathological  changes  to  bring  about  emaciation  and  exhaus- 
tion, the  prognosis  is  unfavorable. 

Treatment.—  Medical.— Anihelmmtics  are  advisable,  and 
especially  those  which  will  be  eliminated  via  the  kidneys. 
Turpentine  (5.0  to  10.0)  repeated  in  forty-eight  hours,  may 
be  given,  if  necessary. 

Surgical.—  Laparotomy  may  be  performed,  and  direct 
examination  made.  If  the  renal  tissue  is  destroyed,  nephrec- 
tomy  would  be  indicated.  (See  Renal  Calculi.) 

Other  Parasites  in  the  Kidney.— A  few  other  species  of 
parasites  are  seen  occasionally,  but  as  they  produce  no  effect 
upon  the  host  they  are  of  no  clinical  importance. 

Cysticercus  cellulosae  and  several  forms  of  coccidia  have 
been  found  on  autopsy. 

Birds  are  not  uncommonly  affected  by  coccidia.  The 
Eirneria  avium  (Coccidium  tenellum)  is  the  one  most  com- 
monly found  in  poultry.  Some  general  disturbances,  such 
as  depression  and  loss  of  appetite,  have  been  noted.  The 
birds  die  of  uremic  poisoning  or  exhaustion. 


CHAPTER    II. 
DISEASES  OF  THE  BLADDER. 

Examination.— A  thorough  and  complete  examination  of 
this  organ  may  be  made,  especially  in  the  dog,  by  palpation 
through  the  rectum,  vagina,  and  abdominal  walls;  by  lapa- 
rotomy  (direct  examination)  and  by  examination  of  the  urine. 

Palpation  can  be  done  satisfactorily  only  in  the  larger 
breeds  when  not  too  fat.  When  palpating  through  the 
abdominal  wall  place  the  animal  in  a  standing  position,  and, 
with  one  hand  on  either  side  of  the  lower  abdominal  wall, 
just  anterior  to  the  brim  of  the  pubis,  exert  enough  pressure 
to  feel  the  bladder  through  the  walls.  In  case  inflammation 
is  present  pain  will  be  evinced.  The  bladder  will  be  felt  as 
a  pear-shaped  enlargement  just  anterior  to  the  brim  of  the 
pubis,  which  is  movable  and  extends  forward  a  varying 
distance  depending  upon  its  distentiqn.  Care  must  be  taken 
to  differentiate  between  a  distended  bladder  and  other 
abnormalities  which  are  commonly  present  in  the  abdominal 
cavity,  such  as  ascites,  fecal  stasis,  neoplasms,  etc. 

Rectal  palpation  is  done  by  first  thoroughly  cleansing  the 
hand  and  the  anal  region  with  soap  and  water,  followed  by 
an  application  of  boric  acid  solution  (2  per  cent.).  The 
index  finger  is  inserted  through  the  anal  opening  as  high  up 
in  the  rectum  as  possible.  The  bladder  can  be  felt  as  a 
distended  body,  projecting  back  into  the  pelvic  inlet.  Dif- 
ferentiation must  be  made  between  a  distended  bladder  and 
chronic  or  acute  prostatitis  which  is  quite  common  in  old 
dogs.  This  can  be  done  by  considering  the  difference  in 
position  and  density  of  the  two  bodies.  Inflammatory 
conditions  of  the  bladder,  which  are  painful  on  pressure,  and 
other  enlargements  such  as  tumors  may  be  found  in  this 
location. 


EXAMINATION  411 

Vaginal  palpation  is  possible  in  the  larger  breeds,  and  is 
performed  in  much  the  same  manner  as  the  rectal.  The 
index  finger  should  be  inserted  as  far  as  possible,  and  if 
the  bladder  is  distended  it  can  be  felt  at  the  pelvic  inlet,  or 
if  it  is  inflamed  slight  pressure  will  be  very  painful.  Vaginitis, 
fecal  accumulations  in  the  rectum,  and  tumors  should  be 
differentiated. 

Laparotomy.— \\\  both  the  male  and  female  dog  it  is  quite 
possible,  safe,  and  practical,  to  perform  this  operation  under 
strict  antiseptic  precautions,  so  that  a  direct  inspection  of 
the  bladder  may  be  made.  In  the  female  the  incision  should 
be  made  just  anterior  to  the  pubis  in  the  median  line,  and  in 
the  male  to  one  side  of  the  penis  but  close  to  the  pubis.  The 
incision  should  be  made  large  enough  (2  or  3  inches)  so  that 
the  bladder  may  be  exposed  to  view.  Care  should  be 
observed  in  cutting  through  the  peritoneum  so  as  not  to  incise 
the  bladder,  as  this  organ  when  distended  will  extend  forward 
in  some  cases  beyond  the  umbilicus.  The  bladder  is  exam- 
ined for  distention  with  urine,  inflammation  (acute  and 
chronic),  calculi,  ulcerations,  paralysis,  etc.  The  laparotomy 
wound  should  be  closed  as  usual.  (See  Laparotomy.) 

Examination  of  the  Urine.— A  sample  of  urine  is  best 
obtained  by  passing  a  catheter,  provided  there  is  any  urine 
present,  or  by  catching  the  urine  in  some  receptacle  as  it  is 
passed  by  the  animal,  Catheterization  has  been  found  to 
be  the  most  practical  method  in  these  animals.  This  is  done 
in  the  male  animal  by  placing  it  in  a  dorsal  position;  restrain 
with  hobbles.  Choose  a  small  sized  human  catheter,  soften 
and  disinfect  by  placing  it  for  ten  to  fifteen  minutes  in  warm 
lysol  solution  (2  per  cent.).  Expose  the  penis  by  pushing 
back  the  prepuce  with  the  left  hand,  and  with  the  right  hand 
insert  the  catheter  into  the  urethral  opening.  Two  normal 
obstructions  will  be  noted  as  the  catheter  is  inserted:  The 
first  one  as  the  catheter  reaches  the  bone  of  the  penis;  the 
other  as  the  catheter  reaches  the  ischial  arch.  The  former 
obstruction  may  be  overcome  by  gentle  pressure;  to  pass 
the  ischial  arch  it  will  sometimes  be  necessary  to  partially 
remove  the  stilet,  and  with  the  finger  direct  the  catheter 
over  this  point.  The  stilet  should  be  gradually  removed 


412  DISEASES  OF  THE  BLADDER 

as  the  catheter  is  inserted.  When  it  reaches  the  bladder,  if 
urine  is  present,  it  will  begin  to  flow  out  at  once.  In  the 
female  animal  the  catheter  is  passed  without  much  difficulty. 
It  is  best  to  place  the  animal  in  a  ventral  position,  securely 
fastened  with  hobbles;  the  same  catheter  as  for  the  male 
animal  can  be  used,  but  best  to  use  a  special  metallic  catheter, 
as  it  can  be  sterilized.  To  insert  the  catheter  a  vaginal 
speculum  is  used  to  dilate  the  vagina,  which  facilitates  inser- 
tion into  the  urethral  opening. 

The  urine  should  be  examined  particularly  for  epithelial 
cells,  pus,  bacteria,  red  blood  cells,  etc.  A  differential 
examination  should  be  made  to  determine  whether  the 
abnormal  constituents  of  the  urine  come  from  the  bladder  or 
some  other  urinary  organ.  Note  the  reaction  of  the  urine, 
its  specific  gravity,  color,  odor,  consistency,  etc. 

WOUNDS  OF  THE  BLADDER. 

The  bladder  is  the  seat  of  several  conditions  produced  by 
trauma  in  the  small  animals:  Traumatic  or  spontaneous 
rupture,  penetrating  wounds  from  bullets  or  other  objects, 
accidental  cutting  of  the  bladder  during  surgical  operations. 

RUPTURE  OF  THE  BLADDER. 

Rupture  of  the  bladder  is  most  often  brought  about  by  the 
animal  being  run  over  by  vehicles,  being  kicked,  falling,  or 
may  be  due  to  overdistention  when  there  is  some  impediment 
to  the  flow  of  urine.  It  can  also  occur  as  the  result  of  the 
walls  being  weakened  by  ulceration  and  other  destructive 
processes.  It  has  been  observed  in  well  broken  house  dogs 
when  confined  for  too  long  a  period,  the  bladder  becoming 
distended  and  finally  paralyzed,  the  continuance  of  the 
secretion  eventually  leading  to  rupture. 

Symptoms.— In  rupture  the  symptoms  develop  in  the 
course  of  a  few  hours.  They  are  complete  suppression  of 
micturition,  general  symptoms  of  collapse,  uriniferous^odor 
of  the  exhaled  air,  subnormal  temperature.  The  history  is 
quite  important,  as  often  the  history  of  an  injury  will  assist 


RUPTURE  OF  THE  BLADDER         413 

in  the  diagnosis  of  rupture.  Passing  the  catheter  will  reveal 
the  empty  bladder.  Examination  by  performing  laparotomy 
should  be  done  as  early  as  possible  in  all  cases  where  rupture 
is  suspected. 

Prognosis. — After  the  development  of  general  symptoms 
of  collapse,  subnormal  temperature,  etc.,  the  condition  is 
considered  unfavorable.  In  cases  of  rupture  where  the 
diagnosis  is  established  early,  or,  in  accidental  cutting 
through  the  walls  of  the  bladder  during  surgical  operations, 
the  prognosis  is  quite  favorable,  provided  prompt  treatment 
is  given. 

Treatment.— Medical.— It  is  always  advisable  to  administer 
stimulants  at  once.  Strychnin  in  small  doses  (0.001). 

Surgical.— Prompt  surgical  treatment  is  absolutely  essen- 
tial for  a  successful  termination. 

The  animal  should  be  properly  prepared  for  laparotomy 
(see  Laparotomy),  and  the  operation  begun  as  soon  as 
possible.  The  abdominal  cavity  should  be  emptied  of  all 
the  retained  urine,  by  flushing  thoroughly  with  normal  salt 
solution,  which  should  be  repeated  two  or  three  times  to  be 
sure  that  all  the  urine  is  removed.  Locate  the  wound  in  the 
bladder  and  suture  with  interrupted  and  Lembert  stitches. 
A  milliner's  needle  will  be  found  to  be  the  best  suturing  needle. 
Place  the  stitches  quite  close  together.  Suture  the  abdominal 
wound  in  the  usual  manner.  The  after-treatment  consists 
in  placing  the  animal  in  a  warm  place  and  using  stimulants 
for  the  first  ten  to  twelve  hours.  Thoroughness  in  treating 
these  cases  will  often  bring  excellent  results. 

Wounds  of  the  bladder,  such  as  gunshot  wounds,  injury 
by  compression  without  complete  rupture,  puncture  by 
fragments  of  bone,  etc.,  are  found  in  the  dog,  and  their 
seriousness  depends  upon  the  degree  of  injury.  In  very 
small  punctured  wounds  and  small  bullet  wounds,  aside  from 
the  symptoms  of  cystitis,  and  stiffness,  no  serious  com- 
plications set  in  and  the  animals  make  prompt  recoveries. 
In  the  other  forms  when  urine  escapes  into  the  peritoneal 
cavity  and  some  hemorrhage  takes  place,  the  case  will  soon 
assume  serious  complications.  (See  Rupture  of  the  Bladder.) 


414  DISEASES  OF  THE  BLADDER 

RETENTION  OF  URINE  IN  THE  BLADDER. 

Retentio  Urince  Vesicalis. 

Definition.— A  collection  of  urine  in  the  bladder,  with 
subsequent  distention  of  the  bladder,  ureters  and  pelvis  of 
the  kidney.  Retention  of  urine  is  a  symptom  of  a  number  of 
independent  conditions  or  diseases  which  are  found  in  the 
dog  and  cat,  often  leading  to  inflammation  of  the  bladder, 
rupture,  peritonitis,  and  uremia. 

Etiology.— Commonly  caused  by  foreign  bodies  in  the 
urethra  or  neck  of  the  bladder  interfering  with  the  voiding 
of  urine.  These  foreign  bodies  consist  mainly  of  calculi  of 
different  kinds,  sediment,  fibrin,  blood  coagula,  etc. 

In  paralysis  of  the  bladder,  the  walls  of  the  bladder  lose 
their  tone.  It  may  be  due  to  affections  of  the  spinal  cord, 
trauma,  various  forms  of  cystitis,  or  to  emaciation  and  general 
weakness,  which  allows  the  bladder  to  distend  enormously. 
The  urine  in  some  cases  will  flow  out  in  a  small  continuous 
stream  after  the  distention  has  reached  a  certain  degree. 

Compression  of  some  portion  of  the  urethra  or  neck  of  the 
bladder  from  without,  such  as  neoplasms,  acute  and  chronic 
prostatitis  which  is  common  in  old  dogs.  Stricture  of  the 
urethra  from  injury  or  surgical  operations;  compression  by 
distention  of  the  uterus  in  pregnancy  and  diseases  of  this 
organ;  diseases  of  the  penis  in  the  male  animal  are  further 
causes. 

Spasmodic  contraction  of  the  sphincter  vesicse,  which  may 
be  due  to  sudden  change  in  temperature  especially  cold 
(chills);  to  some  medicinal  agent  as  strychnin;  to  some 
diseases,  cystitis,  tetanus  (rare). 

Symptoms.— The  early  indication  of  retention  of  urine  is 
ischuria  (suppression  of  urine),  or  painful  micturition  with 
only  a  small  amount  of  urine  passed.  In  the  dog  micturition 
is  accompanied  by  severe  straining. 

In  sensitive  small  animals  there  is  usually  considerable 
abdominal  pain,  resembling  acute  indigestion  or  colic.  The 
back  is  arched  and  the  gait  is  stiff  and  straddling. 

In  a  short  time,  in  case  the  condition  is  not  relieved,  the 
symptoms  will  increase  in  intensity  until  the  bladder  ruptures, 


RETENTION  OF  URINE  IN  THE  BLADDER         415 

in  which  case  the  symptoms  of  pain  will  disappear  for  a  time 
until  peritonitis  and  uremia  develop.  If  the  bladder  ruptures 
symptoms  of  uremia  will  develop  in  a  few  hours.  (See 
Uremia.) 

In  the  dog  the  distention  of  the  bladder  will  produce  a 
noticeable  increase  in  size  of  the  abdominal  cavity.  Careful 
palpation  will  reveal  the  distended  movable  bladder.  When 
rupture  occurs  the  fluid  will  be  detected  free  in  the  abdominal 
cavity.  In  such  case  puncturing  the  a"bdominal  wall  writh  an 
exploring  trocar  will  reveal  the  presence  of  urine.  Care 
should  be  observed,  however,  to  determine  whether  the 
fluid  is  in  the  cavity  or  still  in  the  bladder,  as  the  distended 
bladder  can  extend  well  forward  in  the  abdominal  cavity. 

Diagnosis. — The  symptoms  should  be  noted  carefully.  If 
the  patient  shows  colic,  frequent  micturition,  with  small  quan- 
tities of  urine  passed,  a  careful  and  thorough  examination 
of  the  urinary  organs  should  be  made.  As  retention  of  urine 
in  most  cases  is  secondary  to  some  disease  of  the  urinary, 
organs,  a  careful  examination  should  be  made  to  determine 
the'  primary  condition.  The  examination  may  include 
puncturing  the  abdominal  walls,  laparotomy,  rectal  or  vaginal 
exploration. 

Prognosis.— The  prognosis  depends  principally  upon  the 
possibility  of  relieving  the  primary  condition,  and  whether 
or  not  the  bladder  is  still  intact.  In  case  of  rupture  it  is 
unfavorable,  especially  when  symptoms  of  uremia  are  present. 

Treatment.— The  treatment  must  be  directed  toward 
removing  the  causes.  In  cases  of  paralysis  of  the  walls  of 
the  bladder,  it  is  advisable  to  remove  the  urine  as  early  as 
possible.  This  can  be  done  in  most  cases  by  catheterization. 
Small  doses  of  strychnin  (0.001,  dog)  are  recommended  to 
give  tone  to  the  walls  of  the  bladder. 

In  spasms  of  the  sphincter  vesica1,  catheterization  may  be 
tried;  if  unsuccessful,,  puncture  the  bladder  and  remove  a 
portion  of  the  urine.     A  small  dose  of  morphin  will  overcome  • 
the  spasmodic  contraction,  allowing  the  urine  to  flow  out. 

In  case  an  obstruction  to  the  outflow  of  urine  exists,  treat- 
ment must  be  applied  to  remove  it. 

House-broken  dogs  should  be  allowed  to  run  out  of  doors 
at  regular  intervals  to  avoid  extreme  distention. 


416  DISEASES  OF  THE  BLADDER 

INCONTINENCE  OF  URINE. 

Definition.— A  constant  discharge  of  the  urine  from  the 
bladder;  inability  to  retain  urine. 

Etiology.— Incontinence  may  result  from  several  different 
causes: 

(a)  Affections  of  the  spinal  cord,  as  degeneration,  edema, 
compression  from  hemorrhage,  etc. 

(6)  Paralysis  of  the  sphincter  vesicae. 

(c)  Long  standing  cases  of  retention. 

(d)  Lack  of  tone  of  the  muscles  due  to  senility. 

(e)  Some  cases  of  cystitis. 

(/)  Injury  to  the  sphincter  muscles  from  surgical  opera- 
tions, tumors,  calculi,  etc. 

Symptoms.— Constant  dribbling  of  urine.  Examination 
reveals  the  bladder  empty,  and  the  sphincter  vesicse  relaxed. 

Prognosis.— Depends  upon  the  primary  cause.  Usually 
not  considered  very  favorable  as  recovery  is  rarely  complete. 

Treatment.— Symptomatic.  Determine  the  cause  and  apply 
treatment  to  relieve  it. 

CATARRH  OF  THE  BLADDER. 

Cystitis.      Urocystitis. 

Definition. — A  catarrhal  inflammation  of  the  bladder  which 
may  be  either  acute  or  chronic. 

Etiology.— The  principal  causes  are:  1.  Bacteria  (infec- 
tion), or  irritants  in  the  form  of  toxins,  drugs,  chemicals, 
etc.  Bacteria  gain  entrance  to  the  bladder  in  various  ways: 

(a)  Through  the  genito-urinary  tract.  Catheterization 
of  animals  is  a  common  source  of  infection,  the  organisms 
being  introduced  directly  by  an  infected  catheter.  In  the 
female  germs  are  easily  introduced  into  the  bladder  through 
the  urethra,  which  is  short,  and  its  opening  near  the  vulva. 
A  spread  of  inflammation  from  other  infected  parts  of  the 
urinary  tract,  e.  g.,  pyelitis,  nephritis,  urethritis  may  also 
induce  cystitis.  Retention  of  urine  from  any  cause  leads  to 
decomposition  of  the  urine,  and  lowering  of  the  normal 


CATARRH  OF  THE  BLADDER  417 

resistance  of  the  mucous  membrane  of  the  bladder,  allowing 
infection  to  take  place. 

(6)  Infection  may  gain  entrance  to  the  bladder  from  the 
blood.  In  some  of  the  infectious  diseases,  as  distemper  in 
the  dog  and  cat,  the  bacteria  are  carried  to  the  mucosa  of 
the  bladder  by  the  blood  stream.  In  digestive  disturbances 
(constipation,  etc.)  the  organisms  which  accumulate  in  the 
bowels  enter  the  blood  stream  and  are  eliminated  through 
the  urinary  passages,  often  leading  to  an  acute  cystitis. 
The  colon  bacteria  and  others  more  or  less  closely  related 
are  the  chief  offenders. 

(c)  The  infection  may  spread  from  the  peritoneum,  either 
from  acute  or  chronic  peritonitis,  producing  in  some  cases 
simply  a  pericystitis,  and  in  others  an  involvement  of  the 
entire  bladder  wall. 

2.  Irritating  agents  in  the  form  of  chemicals,  or  drugs, 
when  eliminated  in  large  quantities,  frequently  will  produce 
cystitis.     Cantharides,   turpentine,   balsams,   and   coal   tar 
compounds  given  internally  will  produce  it;  external  applica- 
tions of  easily  diffusible  substances  will,  by  absorption  have 
the  same  effect,  especially  when  applied  over  extensive  areas. 

3.  Sudden  change  in  temperature,  cold  (chills) ,  disturbs  the 
general  circulation,  and  may  lead  to  congestion  of  the  bladder. 
Extreme  cold  affecting  the  body  temperature  might  induce 
extensive  inflammation  of  the  organ. 

4.  Calculi  and  other  foreign  material  often  produce  chronic 
cystitis  by  the  constant  irritation  they  keep  up. 

Pathology.— In  the  early  stages  of  acute  cystitis,  the  mucous 
membrane  will  be  found  reddened,  congested,  much  swollen, 
and  here  and  there  small  hemorrhages  will  be  noted.  There 
is  usually  considerable  thick,  viscid  mucus  covering  the 
membrane,  or  there  may  be  an  admixture  of  pus.  The 
purulent  exudate  often  covers  the  entire  membrane.  In  the 
later  stages  of  the  disease  the  mucosa  is  covered  by  a  croupous 
or  diphtheritic,  yellowish  membrane.  Abscesses  of  various 
size  may  exist  between  the  mucosa  and  the  muscular  walls. 
Erosions  and  ulcerations  on  the  membrane  are  often  the 
result  of  irritating  materials. 

In  the  chronic  form  the  pathological  changes  are  principally 
27 


418  DISEASES  OF  THE  BLADDER 

a  thickening  of  the  mucosa,  which  is  corrugated,  often 
presenting  projecting  growths.  The  muscular  walls  become 
contracted,  thickened  and  incapable  of  distention.  The 
apices  of  the  corrugations  are  darkened,  eroded  and  ulcerated. 
The  bladder  is  usually  empty  and  contracted.  Inflammation 
of  other  portions  of  the  urinary  tract  will  be  more  or  less 
apparent. 

Symptoms.— In  acute  cystitis,  the  animal  will  show  marked 
symptoms  of  difficult  micturition,  severe  straining  as  if  to 
urinate,  with  only  small  quantities  of  urine  passed.  Some- 
times small  quantities  of  blood  follow  the  attempts  to  urinate. 
The  animal  stands  with  the  back  arched,  shows  pain  when 
forced  to  move,  and  stiffness  in  walking.  When  moved  the 
patient  will  cry  out;  it  often  assumes  the  attitude  of  urinating. 
An  erection  of  the  penis  is  a  frequent  symptom.  Pressure 
over  the  region  of  the  bladder  induces  pain.  A  dog  being 
examined  in  the  standing  position  will  often  cry  out  with 
pain,  and  try  to  bite  and  get  away.  Digital  pressure  either 
through  the  rectum  or  vagina  produces  the  same  symptoms. 
In  most  cases  the  bladder  is  found  empty.  Unless  the 
condition  is  mild,  general  symptoms  are  usually  observed. 
The  temperature  is  elevated  in  the  early  stages,  depending 
upon  the  cause  and  kind  of  infection.  Later  it  may  be 
normal  or  subnormal.  Suppression  of  appetite,  thirst,  and 
general  depression  are  often  observed.  Uremic  symptoms 
will  be  found  in  some  cases  due  to  reabsorption  of  urine,  or 
lack  of  elimination  in  cases  where  the  other  urinary  organs 
are  involved.  The  urine,  passed  in  small  quantities,  will  be 
dark  in  color,  contains  varying  amounts  of  albumin,  some- 
times pus,  and  stringy  mucus.  Shreds  of  fibrin  and  necrotic 
membrane  are  passed  in  the  croupous  and  diphtheritic  forms 
of  cystitis.  The  urine  is  usually  alkaline  in  reaction  but 
may  be  acid.  It  will  contain  fibrin,  pus  cells  (both  the  large 
cells  and  the  long  slender  variety),  crystals  of  ammonium 
urate,  and  numerous  bacteria.  The  urine  content  assists 
in  confirming  the  diagnosis.  Chronic  cystitis  produces  much 
the  same  symptoms  but  less  severe  than  in  the  acute  form. 
The  most  noticeable  indications  of  chronic  cystitis  are  painful 
micturition,  the  urine  passed  containing  pus,  red  corpuscles, 


CATARRH  OF  THE  BLADDER  419 

etc.  The  catheter  should  be  inserted  to  differentiate  from 
calculi. 

Diagnosis.— In  acute  cystitis  a  diagnosis  can  be  made  by 
observing  the  symptoms,  making  a  careful  local  examination, 
and  by  analysis  of  the  urine.  Diseases  of  other  portions  of 
the  urinary  tract  should  be  considered.  In  chronic  cystitis 
the  diagnosis  is  made  by  the  examination  of  the  urine,  and 
the  local  examination  of  the  patient.  Calculi  in  the  bladder 
and  urethra  should  be  excluded. 

Prognosis.— In  mild  cases  of  acute  cystitis  the  prognosis 
is  usually  favorable.  In  severe  cases,  owing  to  the  changes 
which  are  produced  in  the  walls  of  the  bladder,  the  prognosis 
is  unfavorable.  Chronic  cystitis  may  run  a  long  course 
without  producing  any  marked  symptoms.  Complete  re- 
covery is  rare.  By  careful  treatment  considerable  improve- 
ment can  be  attained. 

Treatment.—  Dietetic.— Non-stimulating  food  should  be 
given.  Milk  is  perhaps  the  best  as  it  contains  a  large  per- 
centage of  water,  which  is  desirable.  Avoid  giving  meats 
until  the  acute  symptoms  entirely  disappear. 

Medical.— Much  can  be  done  in  acute  cystitis  by  the 
internal  administration  of  antiseptics  and  disinfectants. 
Urotropin  (0.25-0.5)  two  or  three  times  daily  for  dogs;  cats 
should  receive  about  one-fourth  the  quantity.  This  prep- 
aration produces  a  disinfectant  action  owing  to  the  libera- 
tion of  formaldehyd  gas. 

Helmitol  (dog,  1.0-2.0;  cat,  0.1-0.5)  can  also  be  used  for  the 
same  purpose,  administered  either  in  the  form  of  a  powder, 
or  may  be  given  as  a  subcutaneous  injection  in  10  per  cent, 
solution. 

Salol,  salicylic  acid,  and  resorcin  may  be  given  for  a 
similar  action.  In  chronic  catarrh  much  the  same  treatment 
is  recommended  as  in  the  acute  form  of  the  disease. 

Balsam  copaiba,  and  turpentine  in  small  doses  are  recom- 
mended. 

Irrigation  of  the  Bladder.— Irrigation  of  the  bladder,  which 
is  easy  in  the  dog,  in  order  to  remove  infections  and  irritating 
matter,  is  of  great  importance  in  cystitis.  In  the  male  animal 
a  catheter  is  passed  into  the  bladder,  and  the  urine  is  allowed 


420  DISEASES  OF  THE  BLADDER 

to  flow  out.  A  rubber  tube  about  2  or  3  feet  in  length, 
provided  with  a  funnel,  is  attached  to  the  catheter.  The 
tube  is  elevated  and  a  warm,  normal  salt  solution  (40.0-70.0) 
allowed  to  flow  into  the  bladder.  The  tube  is  then  depressed 
to  siphon  out  the  fluid.  Following  the  injection,  it  is 
advisable  to  use  some  of  the  mild  disinfectants  as  boric  acid 
(2  per  cent.),  or  ichthyol  solution  (1-2  per  cent.).  These 
should  be  allowed  to  remain  in  the  bladder  five  to  ten  min- 
utes and  then  removed.  The  injection  should  be  repeated  in 
eight  to  twelve  hours.  In  females  the  injections  are  made 
much  in  the  same  way.  Sometimes  in  the  male,  when 
injections  are  to  be  made  often,  the  urethra  becomes  irritated 
from  the  frequent  passing  of  the  catheter.  In  such  cases  a 
temporary  urethrotomy  may  be  performed  at  the  ischial 
arch,  and  the  injections  made  from  this  point.  Thorough 
application  of  these  solutions  will  often  produce  most 
excellent  results. 


TORSION  OF  THE  BLADDER. 

This  condition  has  been  found  to  occur  occasionally  in  the 
dog.  It  leads  to  retention  of  urine  and  eventually  to  rupture 
of  the  bladder.  Death  occurs  from  peritonitis  and  uremia. 
Surgical  relief  should  be  attempted. 


CALCULI  IN  THE  BLADDER. 

Calculi  are  more  common  in  the  dog  than  in  any  other  small 
animal.  They  appear  in  various  sizes  and  forms.  In  some 
cases  they  are  very  small  and  multiple;  in  others  a  single, 
rounded  concretion,  conforming  to  the  shape  of  the  bladder, 
is  found. 

Etiology.— The  factors  producing  concretions  in  the  bladder 
may  be  classed  under  three  headings: 

(a)  Local  disturbance  in  the  urinary  organs.  In  this  case 
there  will  be  found  degenerative  changes  from  the  products 
of  the  urine  (uric  acid),  leading  to  necrosis  of  the  cells,  such 
products  forming  the  nucleus  around  which  the  salts  deposit. 


CALCULI  IN  THE  BLADDER  421 

(6)  Disturbances  of  metabolism  in  which  there  will  be  a 
larger  quantity  of  material  eliminated  in  the  form  of  phos- 
phates, carbonates,  oxalates  (calcium  and  ammonium 
oxalate),  uric  acid,  urates  (ammonium  urate),  etc.  The 
excess  of  these  salts  becomes  deposited  around  the  organic 
nucleus,  leading  to  bladder  calculus. 

(c)  The  administration  of  foods  rich  in  salts  of  various 
kinds  will  increase  the  quantity  in  the  body,  and  .consequently 
more  salts  will  be  eliminated. 

Forms  and  Varieties.  —  1 .  Acid  Urine  Calculi,  (a)  Uric 
Acid  Calculi  (Ammonium  Urate). — These  are  small,  hard, 
smooth  calculi,  of  a  reddish  or  yellowish-brown  color.  They 
are  perhaps  the  most  common  kind  found  in  the  dog. 

(b)  Oxalate  Calculi  (Calcium  and  Ammonium  Oxalate).— 
In  form  these  calculi  are  rough  on  the  surface,  irregular  in 
shape,  and  usually  when  removed  are  of  a  dirty  white  or 
yellowish  color. 

(c)  Cystin  Calculi.— Soft  waxy  bodies,  which  no  doubt 
result  from  disturbed  metabolism  of  nitrogenous  substances. 
Their  color  is  brown  or  brownish-yellow.     They  are  soft 
enough  in  most  cases  to  be  crushed  between  the  fingers. 

2.  Alkaline  Urine  Calculi.— There  will  be  found  various 
forms  of  these  concretions,  such  as  phosphates  and  carbonates 
predominating,  and  in  combination  with  other  salts,  etc. 
These  calculi  occur  either  multiple,  as  particles  of  sand  or 
grit,  or  in  single,  large  concretions.  They  are  hard,  irregular, 
rough  or  smooth  stones,  of  a  white,  yellowish  or  dirty  color, 
which  are  usually  flattened,  oval  or  oblong. 

The  recognition  of  the  different  varieties  of  calculi  is 
important  from  the  standpoint  of  recurrence  and  treatment 
following  their  removal. 

Symptoms.—  The  acid  concretions  do  not,  as  a  rule,  produce 
any  marked  symptoms,  except  as  they  impede  the  flow  of 
urine. 

The  large,  alkaline  stones  are  most  productive  of  clinical 
symptoms,  and  the  ones  which  require  the  most  radical 
treatment.  There  will  be  symptoms  of  a  catarrhal  inflam- 
mation of  the  bladder,  and  pus  is  discharged  with  the  urine. 
Micturition  is  painful,  and  only  small  quantities  of  urine  are 


422  DISEASES  OF  THE  BLADDER 

passed.  Attention  is  usually  called  to  the  case  by  the  con- 
stant dribbling  of  urine. 

Examination  of  the  bladder  is  necessary  to  determine  the 
presence  of  the  calculus.  This  may  be  made  either  by  digital 
examination  through  the  rectum,  by  abdominal  palpation, 
or  by  laparotomy.  (See  Examination  of  Bladder.) 

Prognosis.— Cases  when  taken  early  before  systemic  dis- 
turbances make  their  appearance  from  absorption  of  urine, 
etc.,  are  favorable.  However,  the  local  disturbances  in  the 
bladder  produced  by  the  calculi  should  be  taken  into  con- 
sideration, for  sometimes  serious  alterations  difficult  to  heal 
will  be  found  in  the  mucosa. 

Treatment.— Surgical  treatment  is  the  only  satisfactory 
method  of  removing  calculi  from  the  bladder.  In  the  male 
animal  the  following  procedure  has  been  found  to  be  the  most 
efficient. 

The  animal  is  prepared  for  operation  by  being  given  an 
anesthetic,  placed  on  the  table  in  the  dorsal  position,  and 
the  field  of  operation  just  anterior  to  the  pubis  and  lateral 
to  the  penis  shaved  and  disinfected.  The  incision  should 
be  2  to  3  inches  in  length,  so  that  the  bladder  can  be  exposed. 
After  exposing  the  bladder  it  should  be  well  protected  with 
gauze  to  prevent  urine  from  flowing  into  the  cavity  when 
incised.  The  incision  is  made  through  the  walls  of  the 
bladder  where  bloodvessels  show  the  fewest  anastomoses. 
It  should  be  of  sufficient  size  to  remove  the  calculus.  After 
the  removal  of  the  calculus  the  mucosa  of  the  bladder  should 
be  examined  for  smaller  stones  or  deposits,  and  if  any  are 
found  they  should  also  be  removed  with  a  blunt  curette. 
The  mucosa  is  then  swabbed  with  gauze  saturated  in  an  anti- 
septic solution.  The  wound  in  the  bladder  is  sutured  with 
a  double  row  of  sutures  bringing  the  serous  coats  in  direct 
approximation.  The  sutures  should  be  placed  close  together 
to  prevent  the  urine  escaping  until  adhesion  takes  place. 
The  laparotomy  wound  is  closed  and  protected  in  the  usual 
manner.  In  the  female  two  methods  are  employed: 

(a)  The  animal,  well  hoppled,  is  placed  in  the  ventral 
position  on  the  table.  A  vaginal  speculum  is  used  to  dilate 
the  vagina.  A  grooved  director  is  inserted  into  the  urethra 


PARASITES  IN  THE  BLADDER  423 

and  with  a  probe-pointed  knife  the  urethra  is  incised  back  to 
the  neck  of  the  bladder.  The  stone,  if  not  too  large,  is  grasp- 
ed with  a  suitable  forceps  and  removed.  After  removal  the 
bladder  should  be  flushed  out  with  a  warm  boric  acid  solution 
(2  per  cent.).  The  vagina  should  be  flushed  out  daily  for  a 
few  days. 

(6)  In  case  the  stone  is  too  large  to  be  removed  through 
the  neck  of  the  bladder  without  injuring  the  sphincter  vesicse, 
the  operation  for  cystotomy  should  be  performed  as  in  the 
male. 

The  after-treatment  consists  in  irrigation  of  the  bladder 
(see  Cystitis),  and  feeding  plenty  of  milk  and  no  meat  for  a 
week  or  ten  days.  In  some  cases  when  hemorrhage  takes 
place  following  the  operation,  the  catheter  should  be  passed 
daily  to  remove  the  urine  and  any  clots  which  might  form. 


TUMORS  OF  THE  BLADDER. 

There  are  a  few  varieties  of  tumors  found  involving  this 
organ.  The  most  common  ones  are:  Sarcomata,  carci- 
nomata,  and  fibromata.  They  will  be  recognized  by  the 
symptoms  of  chronic  cystitis  they  produce,  by  the  examina- 
tion of  the  urine  and  of  the  bladder.  If  necessary  laparotomy 
may  be  performed  and  the  bladder  examined  direct.  (See 
Examination  of  the  Bladder.) 

Prognosis.— This  is  not  very  favorable,  especially  if  the 
tumor  is  malignant. 

Treatment.— Resection  of  a  portion  of  the  bladder  wall 
is  to  be  recommended  when  the  tumor  formation  is  localized, 
otherwise  no  treatment  can  be  given.  Irrigate  the  bladder 
in  the  same  manner  as  in  cystitis.  (See  Cystitis.) 


PARASITES  IN  THE  BLADDER. 

The  Dioctophyme  renale  parasite  is  found  occasionally  in 
the  bladder.  A  few  cases  have  been  recorded  in  which 
species  of  parasites  found  in  the  blood  became  located  in 


424  DISEASES  OF  THE  BLADDER 

the  wall  of  the  bladder.  Symptoms  of  catarrhal  inflam- 
mation of  the  bladder,  with  the  presence  of  eggs  in  the 
urine,  will  assist  in  making  the  diagnosis.  Should  eggs  be 
found  in  the  urine,  it  then  becomes  necessary  to  definitely 
locate  the  parasite. 

Treatment. — Treatment  consists  in  removal  of  the  para- 
sites by  cystotomy,  and  the  subsequent  irrigation  of  the 
bladder  with  antiseptics. 


CHAPTER   III. 
DISEASES  OF  THE  URETHRA. 

Examination.  — The  urethra  may  be  examined  in  two 
ways : 

(a)  In  the  male  it  is  possible  to  palpate  from  without 
along  its  course  until  it  passes  over  the  ischial  arch;  the  part 
within  the  pelvis  may  be  palpated  through  the  rectum. 
Palpation  will  reveal  sensitiveness  in  cases  of  urethritis  and 
calculi  lodged  at  some  point  along  its  course.  There  arc 
three  parts  of  the  urethra  in  which  calculi  are  most  apt 
to  lodge:  At  the  neck  of  the  bladder;  where  the  prostate 
glands  practically  surround  it,  and  at  the  posterior  end  of 
the  bone  of  the  penis.  At  these  points,  owing  to  the  struc- 
ture of  the  urethra  and  adjacent  parts,  any  foreign  material 
passed  from  the  bladder  is  most  apt  to  become  lodged.  In 
the  female  the  urethra  can  be  palpated  through  the  vagina. 
In  the  female,  the  urethra,  as  a  rule,  is  free  from  foreign 
material,  because  any  substance  of  this  kind  small  enough 
to  pass  from  the  bladder  into  the  urethra,  will  be  forced  out 
with  the  urine. 

(6)  The  passage  of  the  catheter  or  sound  is  a  valuable 
means  of  determining  the  sensitiveness  of  the  mucous  mem- 
brane, the  presence  of  calculi  or  other  foreign  material,  or 
strictures  at  different  points  along  the  course  of  the  urethra. 
Care  should  be  taken  in  inserting  the  catheter  not  to  injure 
the  urethral  mucosa;  also  one  should  not  mistake  the  normal 
narrowing  of  the  lumen  of  the  urethra  for  strictures,  etc. 

CONGENITAL  MALFORMATIONS. 

Occlusion  of  the   Urethra. 

Occlusion  of  the  urethra  is  occasionally  found  in  both  the 
male  and  female.  Sometimes  an  opening  exists  in  some  other 
portion  of  the  urethra  through  which  the  urine  is  discharged. 


426  DISEASES  OF   THE   URETHRA 

Various  kinds  of  abnormalities  have  been  observed,  such  as 
epispadia  and  hypospadia. 

Symptoms.— Occlusion  of  the  urethra  at  its  outlet  is 
characterized  in  young  animals  by  a  retention  of  urine, 
enlargement  of  the  abdomen,  and  no  signs  of  micturition. 
The  distended  bladder  will  be  found  on  examination. 

Treatment.— Surgical  treatment  should  be  given  at  once. 
If  the  occlusion  is  at  the  extreme  end  of  the  urethra  it  should 
be  incised  at  this  point  and  the  flaps  stitched  back  to  the 
skin  to  prevent  adhesions  taking  place.  The  urine  will 
usually  keep  the  wound  open.  Should  the  occlusion  be  at 
a  point  higher  up,  in  a  male  dog,  an  artificial  opening  should 
be  made  at  the  ischial  arch  through  which  the  urine  is 
allowed  to  pass.  It  may  be  necessary  for  this  opening  to 
be  used  permanently,  in  which  case  the  edges  of  the  mem- 
brane on  either  side  should  be  stitched  back  to  the  skin,  and 
kept  clean  for  several  days  until  union  takes  place.  In 
the  female  the  urethra  should  be  opened  with  a  pair  of 
scissors,  and  kept  dilated  with  a  metallic  catheter  used 
daily. 

WOUNDS  OF  THE  URETHRA. 

It  happens  occasionally  when  animals  are  injured  that 
the  urethra  will  be  opened  at  some  point  along  its  exposed 
portion.  It  will  be  made  manifest  by  the  presence  of  a 
wound  through  which  urine  escapes.  Internal  wounds  of 
the  mucosa  occur  from  the  careless  use  of  a  catheter  or 
sound,  or  by  foreign  bodies  passing  from  the  bladder,  or 
by  weeds  or  straws  entering  the  urethral  outlet. 

Treatment.— In  extensive  and  severe  lacerations  of  the 
urethra  they  should  be  sutured,  and  the  wound  well  pro- 
tected. In  a  short  time  union  will  take  place  and  the 
urine  passed  normally.  Injuries  to  the  mucosa  are  treated 
by  injecting  mild  antiseptic  solutions  (boric  acid  2  per  cent). 

STRICTURE  OF  THE  URETHRA. 

Definition.— A  constriction  of  the  wall  of  the  urethra 
which  narrows  the  lumen  and  interferes  with  the  passage 
of  urine. 


CALCULI  IN   THE   URETHRA  427 

Etiology.— This  is  brought  .about  by  a  number  of  condi- 
tions which  lead  to  injury  of  the  mucous  membrane,  and  in 
the  healing  process  to  the  formation  of  cicatricial  tissue 
with  narrowing  of  the  lumen,  and  loss  of  elasticity  in  the 
urethral  wall.  The  most  common  causes  of  stricture  are: 
Calculi,  tumors,  urethritis  and  torsion  of  the  urethra  occur- 
ring during  copulation. 

Symptoms.— Impeded  or  complete  suppression  of  micturi- 
tion, with  straining  and  pain.  Bladder  distended.  In  some 
cases  small  quantities  of  urine  will  be  passed  after  much 
straining. 

Diagnosis.— The  diagnosis  is  made  by  noting  the  symp- 
toms, and  the  passage  of  a  sound  or  catheter.  Stricture 
of  the  urethra  should  not  be  confused  with  calculi  and 
prostatic  enlargement. 

Prognosis.— Not  very  favorable,  as  complete  recovery  is 
rare. 

Treatment. — The  passage  of  a  sound  or  catheter  daily  for 
a  time  will  tend  to  dilate  the  urethra.  The  catheter  or 
sound  should  be  well  disinfected  each  time  to  avoid  infec- 
tion in  the  urethra  or  bladder.  No  other  treatment  has 
proved  of  any  value. 

CALCULI  IN  THE  URETHRA. 

Frequently  in  the  male  dog  calculi  are  found  at  some 
point  along  the  course  of  the  urethra.  These  stones  are 
passed  from  the  bladder  and  are  of  sufficient  size  to  become 
lodged  in  the  urethra  at  the  prostate  gland  and  at  the  os 
penis.  While  they  usually  consist  of  one  or  more  concre- 
tions, in  some  cases  an  impacted  mass  of  small  stones  ^with 
blood  or  fibrin  clot  forms  the  stoppage.  Occasionally  there 
will  be  found  injury  to  the  mucous  membrane,  the  stones 
passing  out  in  part  into  the  adjacent  tissues. 

Symptoms.— When  the  calculi  become  lodged  in  the  urethra 
marked  symptoms  develop  in  a  short  time.  If  there  is 
complete  stoppage  of  urine,  the  animal  will  soon  show  dis- 
tress, frequent  attempts  at  micturition,  straddling,  stiff 
gait,  evidences  of  urinary  pain  or  colic.  Examination  of 


428  DISEASES  OF  THE   URETHRA 

the  bladder  will  reveal  its  distended  condition.  Should  the 
condition  continue  for  several  hours  the  urine  will  be  dammed 
back  to  produce  distention  of  all  the  urinary  passages.  Pas- 
sage of  the  sound  or  catheter  will  reveal  the  obstruction  in 
the  urethra.  In  the  female,  by  inserting  the  fingers  in  the 
vagina,  the  enlargement  can  be  felt. 

Prognosis. — Favorable  in  case  treatment  can  be  given 
promptly.  The  complications,  paralysis  or  rupture  of  the 
bladder,  should  be  taken  into  consideration,  as  they  are 
apt  to  occur  if  treatment  is  delayed  too  long. 

Treatment.— Surgical  treatment  is  resorted  to  promptly 
to  prevent  rupture  of  the  bladder.  In  case  rupture  threat- 
ens, use  a  long,  disinfected,  exploring  trocar,  disinfect  the 
skin  in  the  prepubic  region,  place  the  animal  in  a  dorsal 
position  and  insert  the  trocar  through  the  abdominal  wall 
into  the  bladder.  Allow  the  urine  to  flow  out,  remove  the 
trocar  and  cover  the  wound  with  flexible  collodion.  There 
is  usually  but  little  danger  of  injuring  the  bowels,  as  the 
distended  bladder  pushes  them  to  one  side.  Urethrotomy 
should  then  be  performed.  In  the  male  an  anesthetic 
(morphin  or  chloroform)  should  be  administered,  and  the 
patient  placed  on  the  table  in  a  dorsal  position  with  the 
hind  legs  brought  forward.  The  sound  or  catheter  is 
inserted  as  a  guide  to  locate  the  calculus,  and  also  to  assist 
in  making  the  incision.  The  seat  of  operation  will  depend 
upon  the  location  of  the  calculus.  When  located  just 
posterior  to  the  os  penis,  the  incision  is  made  at  the  distal 
portion  of  the  enlargement.  Should  the  calculus  be  at  the 
prostatic  portion  of  the  urethra  the  operation  should  be 
performed  at  the  ischial  arch.  The  seat  of  operation  should 
be  thoroughly  cleaned  and  disinfected.  The  incision  is 
made  immediately  over  the  sound  which  can  be  distinctly 
felt.  This  should  be  made  of  sufficient  size  to  allow  the 
calculus  to  be  removed  without  injuring  the  adjacent  tissues. 
In  some  cases,  when  the  tissues  are  lacerated,  they  become 
infiltrated  with  urine  and  cause  considerable  trouble  fol- 
lowing the  operation.  After  the  removal  of  the  calculus, 
if  any  urine  is  present,  it  will  flow  out;  should  this  fail  to 
occur  examine  further  for  other  calculi  by  passing  the  sound 


INFLAMMATION  OF  THE  URETHRA  429 

beyond  the  point  of  operation.  When  the  calculus  is  in 
the  prostatic  portion  of  the  urethra,  the  sound  should  be 
passed  as  before  and  the  incision  made  at  the  ischial  arch, 
cutting  down  to  the  catheter  or  sound.  The  urethra  then 
is  dilated  by  either  passing  a  larger  sound,  or  by  inserting 
a  grooved  director  and  enlarging  it  with  a  probe-pointed 
knife.  The  calculus  is  then  extracted  by  using  a  strong 
dressing  forceps.  In  some  cases  it  may  be  crushed  with 
lithotomy  forceps  and  taken  out  in  pieces. 

In  the  female  the  operation  is  much  more  simple.  In 
some  cases  the  calculus  can  be  removed  by  manipulating  it 
with  the  finger  inserted  in  the  vagina.  Should  this  fail  the 
urethra  must  be  dilated  or  enlarged  sufficiently  to  admit 
forceps  for  its  extraction.  It  is  best  to  use  a  grooved  director 
and  with  a  probe-pointed  knife  the  urethra  is  divided  up 
to  the  stone,  where  it  can  be  extracted  with  forceps. 

After-treatment  consists  in  flushing  out  the  bladder  with 
some  mild  antiseptic  solution,  such  as  sodium  bicarbonate 
(2  per  cent.)  or  boric  acid  (2  per  cent.).  The  wound  should 
be  left  open  and  kept  clean  with  antiseptics.  The  urine 
will  at  first  pass  out  through  the  incision,  but  as  the  wound 
fills  in  by  granulation,  eventually  it  will  be  voided  normally. 
In  the  female  the  vagina  should  be  cleansed  daily  with 
antiseptics. 

INFLAMMATION  OF  THE  URETHRA. 

Urethritis. 

Urethritis  is  not  a  common  primary  condition  in  small 
animals,  but  it  sometimes  accompanies  other  diseases  of 
the  urinary  organs.  A  primary  urethritis  results  from 
infection  due  to  the  introduction  of  a  sound  or  catheter  or 
from  injuries  during  copulation,  etc. 

Symptoms. — Painful  micturition.  Pus  and  blood  can  be 
pressed  out  of  the  urethra. 

Treatment.— Antiseptic  solutions,  such  as  boric  acid  (2 
per  cent.)  or  sulphate  of  zinc  (1  per  cent.)  are  to  be  used 
as  injections  into  the  urethra  and  prepuce. 


PART  IX. 
DISEASES  OF  THE  NERVOUS  SYSTEM. 


CHAPTER  I. 
DISEASES  OF  THE  BRAIN. 

General  Considerations.— Diseases  of  the  central  nervous 
system  are  usually,  for  the  purpose  of  convenience  and 
pedagogy,  classified  into  those  affecting  the  encephalon  or 
brain,  those  affecting  the  spinal  cord,  and  those  affecting 
the  peripheral  nerves. 

This  seems  to  be  a  logical  classification,  and  this  method 
will  be  followed  in  presenting  the  diseases  of  the  nervous 
system.  In  order  to  correctly  diagnose  diseases  of  this 
system,  a  knowledge  of  its  functions  as  well  as  the  seat  of 
each  function  is  required.  These  will,  therefore,  be  con- 
sidered briefly. 

Preliminary  remarks  on  the  functions  and  seat  of  each: 

Cortex.— The  cortex  of  the  cerebral  hemispheres  is  the 
seat  of  all  psychic  function,  such  as  thought,  the  will  and 
sensation,  and  all  efferent  nerve  fibers  originate  here.  The 
voluntary  motor  fibers  also  originate  in  the  cortex,  pass 
through  the  pons  to  the  medulla  oblongata  where  they 
cross  to  the  opposite  side  and  communicate  with  the  motor 
nerves  of  the  extremities.  All  sensory  nerve  fibers  and 
fibers  of  special  sense  which  conduct  perceptible  impulses 
to  the  brain  terminate  in  the  cortex.  The  cortex  of  the 
cerebrum,  then,  being  the  seat  of  the  mind  and  of  voluntary 
movement,  it  follows  that  any  destructive  process  affecting 
this  portion  of  the  brain  will  produce  psychic  or  mental 


432  DISEASES  OF  THE  BRAIN 

disturbances  as  well  as  impaired  mobility  and  sensation  on 
the  opposite  side  of  the  body,  the  degree  of  impairment 
depending  upon  the  extent  of  the  lesion. 

The  Midbrain  (Crura  Cerebri,  Corpora  Quadrigemini  and 
Optic  Thalami).—This  portion  of  the  brain  is  the  seat  of 
harmony  of  motion  and  equilibrium. '  As  some  of  the  cranial 
nerves  arise  here,  the  fifth  pair  being  the  most  important 
of  these,  any  disease,  destructive  process  or  undue  pressure 
operating  on  this  part  of  the  brain  will  produce  sensory 
and  motor  disturbances  in  the  region  of  the  face,  lips,  eyes, 
ears  and  part  of  the  tongue,  and,  if  extensive,  the  entire 
organism  may  be  affected.  Involuntary  movements  of  the 
limbs,  head,  neck  and  eyes  are  the  most  common  symptoms 
resulting. 

The  Cerebellum.— The  functions  of  the  cerebellum  or  hind- 
brain  are  not  fully  known  but  it  is  regarded  as  being  closely 
connected  with  locomotion  and  equilibrium.  It  is  also 
thought  to  be  the  seat  of  the  muscle  sense  and  assists  in  the 
coordination  of  the  muscle  movements.  Each  hemisphere 
of  the  cerebellum  presides  over  the  muscles  of  the  same  side 
of  the  body  and  if  either  half  be  injured  or  diseased  the 
animal  will  exhibit  muscular  and  motor  disturbances  of 
the  same  side,  varying  in  degree  from  slight  muscular 
incoordination  to  spasmodic  movements,  or  it  may  walk 
in  a  circle  or  crowd  or  roll  toward  the  injured  hemisphere. 

Examination.— The  brain,  because  of  its  position,  pro- 
tected by  the  bones  of  the  cranium,  cannot  be  examined 
directly.  Diseases  of  this  organ  can  be  recognized  only 
by  observing  the  disturbed  functions  produced  after  patho- 
logical changes  have  occurred.  It  is  necessary,  therefore, 
to  examine  carefully  the  functions  of  the  brain  before  one 
can  arrive  at  definite  conclusions. 

As  the  brain  is  the  seat  of  the  mind  (thought),  feeling, 
consciousness,  sensibility  and  voluntary  movement,  any  dis- 
turbances or  impairment  of  these  functions  must  be 
attributed  to  some  pathological  change  in  that  organ. 

Taking  up  the  examination  of  the  brain  by  examining  its 
functions  in  the  order  named  above,  the  psychic  function  or 
mental  condition  will  be  first  considered. 


EXAMINATION  433 

1.  PSYCHIC  DISTURBANCES. — Any  variation  from  the  nor- 
mal mental  condition  is  manifested  by  abnormal  excitability, 
or  abnormal  depression. 

(a)  Mental  Excitement.— Abnormal  mental  excitement  is 
caused  by  cerebral  irritation  involving  particularly  the 
cortex.  This  may  be  due  to  hyperemia,  inflammatory 
changes,  excessive  heat  or  toxic  influence.  The  degree  of 
excitement  may  vary  from  restlessness  to  mania.  In  these 
attacks  docile  animals  may  become  vicious,  bite  animate 
or  inanimate  objects,  or  even  their  own  flesh;  may  stand 
up  on  their  hind  legs,  froth  at  the  mouth,  and  the  eyes  show 
a  vacant,  staring  expression,  conjunctiva  injected.  These 
symptoms  may  gradually  subside  or  they  may  terminate 
in  spasms  and  convulsions. 

(6)  Mental  Depression.— This  may  be  defined  as  a  dulling 
of  the  psychic  functions  and  may  vary  in  degree  from  dul- 
ness  to  coma.  Mental  depression  is  shown  by  the  animal 
taking  less  interest  in  its  surroundings  than  usual,  drooping 
of  the  head  and  tail,  refusing  to  obey  commands  or  obeys 
slowly  or  clumsily;  it  assumes  somnolent  or  lethargic  atti- 
tudes or  may  wander  aimlessly  about  running  into  objects, 
etc.  These  are  the  milder  manifestations  of  depression  and 
are  seen  in  subacute  and  chronic  diseases  affecting  the  brain 
chiefly  the  cortex.  They  may  occur  in  acute  infectious 
diseases,  as  the  early  stages  of  distemper,  rabies,  in  severe 
febrile  diseases,  and  in  icterus  and  uremia.  Other  degrees 
of  mental  depression  are  shown  by  somnolency,  a  condition 
in  which  the  animal  appears  to  be  asleep,  but  from  which 
it  may  be  roused;  or  sopor,  deep  sleep  from  which  it  is 
difficult  to  rouse  the  animal,  and  coma,  or  complete  uncon- 
sciousness. These  conditions  are  produced  by  more  severe 
or  extensive  lesions.  They  are  seen  in  compression  of  the 
brain,  cerebral  hemorrhage  and  tumors  of  the  brain.  They 
may  be  accompanied  by  motor  disturbances  in  addition  to 
the  mental  symptoms,  since  these  conditions  may  involve 
the  deeper  structures  of  the  brain  as  well  as  the  cortex. 

2.  SENSIBILITY.— Disturbances  of  sensation  may  be  con- 
sidered as  of  two  types,  viz.:    (a)  Pathological  excitation  or 
hyperesthesia  and  (b)  pathological  depression  or  anesthesia. 

28 


434  DISEASES  OF  THE  BRAIN 

• 

Hyperesthesia  when  observed  in  small  animals  is  usually 
due  to  some  of  the  infectious  diseases,  and  is  seen  in  the 
early  stages  of  rabies,  in  tetanus,  and  in  some  of  the  milder 
diseases  of  the  cerebrum  as  hyperemia  and  acute  cerebritis. 
Hyperesthesia  is  manifested  by  abnormal  movements  of  the 
animal  which  are  entirely  out  of  proportion  to  the  stimulus 
applied.  For  example,  slamming  the  door  or  clapping  the 
hands  may  so  excite  the  animal  that  it  will  fall  to  the  floor 
or  ground  in  spasms.  Local  or  peripheral  hyperesthesia  is  of 
little  or  no  importance  in  small  animal  practice. 

Anesthesia.—  This  is  a  condition  in  which  there  is  a  com- 
plete loss  of  sensation.  Hyperesthesia  indicates  a  condition 
in  which  tactile  sensibility  is  merely  decreased.  Dimin- 
ished sensibility  may  be  general  or  complete,  affecting  the 
entire  animal,  as  in  subacute  or  chronic  inflammatory 
conditions  of  the  cortex  of  the  brain  and  its  coverings.  It 
may  be  partial  or  incomplete,  affecting  one  entire  side, 
having  its  origin  in  one  hemisphere,  that  of  the  opposite  side. 
Or  it  may  be  local,  circumscribed,  when  more  or  less  exten- 
sive areas  of  the  cerebrum  are  involved.  Depression  of 
sensibility  is  determined  by  applying  some  stimulus,  which 
when  applied  to  the  normal  animal  will  cause  pain.  To 
test  sensibility  the  skin  is  pricked  with  a  needle  or  pin, 
pinched  or  burned  with  a  heated  instrument.  If  the  animal 
fails  to  react,  that  is,  does  not  show  pain  by  crying  out, 
whining,  or  trying  to  get  away  from  the  irritant,  the  area 
or  part  tested  is  anesthetic. 

Motility.— Disturbances  of  motility  arising  from  the 
brain  vary  in  degree  from  slight  incoordination  to  complete 
paralysis.  They  will  vary  in  extent  and  character,  depend- 
ing upon  the  location  and  size  of  the  lesion.  Disturbed 
motility  may  be  classified  into  (a)  hyperkinesis  or  exag- 
gerated action  as  seen  in  spasms  and  involuntary  movements, 
and  (6)  akinesis  or  decreased  action  such  as  occurs  in  loss 
of  the  muscular  sense  and  in  paralysis.  Disordered  motility 
may  arise  from  pathological  changes  in  the  brain  or  in  the 
spinal  cord.  In  examining  disturbances  of  motility,  itiis 
sometimes  impossible  to  locate  definitely  the  seat  of  the 
lesion.  However,  if  the  impaired_  function  is  accompanied 


HYPEREMIA  OF  THE  BRAIN  435 

by  mental  disturbances,  the  brain  may  be  regarded  as 
being  the  seat  of  the  lesion.  If,  on  the  other  hand,  no 
mental  disturbances  are  noted,  it  is  assumed  that  the  lesion 
is  in  the  cord.  Further,  the  portion  of  the  animal  affected 
will  often  point  to  the  origin  of  the  disturbance.  Hemi- 
plegia,  or  paralysis  of  one-half  of  the  body,  and  monoplegia, 
paralysis  of  a  single  organ  or  part,  indicate  that  the  disturb- 
ance is  of  cerebral  origin,  while  paraplegia,  a  paralysis  of  a 
portion  of  both  sides,  indicates  spinal  paralysis. 

HYPEREMIA  OF  THE  BRAIN. 

Congestion  of  the  Brain. 

Definition.—  Hyperemia  is  a  condition  in  which  there  is 
an  engorgement  of  the  vessels  of  the  brain.  The  engorge- 
ment may  be  active  or  passive. 

Etiology.— Active  hyperemia,  or  congestion  of  the  brain, 
may  be  caused  by  anything  which  affects  the  cerebral 
arterial  circulation.  Violent  exercise,  excitement,  espe- 
cially in  young  animals,  blows  and  concussion  on  the  head, 
are  causes.  It  may  accompany  eruption  of  the  permanent 
teeth,  or  abnormal  heart  action  as  in  hypertrophy  of  the  left 
ventricle.  Excessive  heat,  as  direct  sunlight  upon  the  head' 
in  hot  weather,  will  also  produce  active  hyperemia. 

Infective  hyperemia  of  the  brain  appears  secondarily  to 
some  of  the  infectious  diseases,  the  most  common  being 
rabies  and  distemper. 

Pass-ire  Hyperemia. — The  causes  of  passive  hyperemia  of 
the  brain  are  chiefly  mechanical,  and  may  be  anything 
which  impedes  the  outflow  of  the  blood  from  the  brain. 
Tight  collars  will  compress  the  jugular  veins  and  produce 
it.  Tumors  and  enlarged  thyroid  glands  (goiter),  valvular 
insufficiency  of  the  left  heart,  chronic  diseases  of  the  lungs 
as  interstitial  pneumonia,  may  produce  a  passive  hyperemia. 

Pathology.— In  severe  hyperemia  of  the  brain,  the  dura 
mater  or  outer  covering  will  be  found  injected  and  in  cases 
of  long  standing  may  be  adherent  to  the  bones  of  the  cranial 
cavity.  The  pia  mater  or  inner  membrane  is  hyperemic 
and  the  blood  vessels  engorged.  The  gray  matter  varies 


436  DISEASES  OF  THE  BRAIN 

from  a  gray  to  a  pinkish  color,  and  the  white  matter  a 
yellowish-red.  Between  the  brain  and  its  covering  mem- 
brane, and  between  the  membranes  themselves  there  is  an 
abnormal  amount  of  fluid;  the  brain  substance  itself  is 
abnormally  infiltrated  with  serum.  In  very  severe  hyper- 
emia  there  may  be  ecchymoses  or  petechise  present  either  in 
the  substance  of  the  brain  or  its  membranes. 

Symptoms.— The  symptoms  of  active  hyperemia  of  the 
brain  vary,  depending  upon  the  severity  of  the  engorge- 
ment and  the  degree  of  intracranial  tension.  In  mild  cases 
there  may  be  only  symptoms  of  restlessness  shown,  the 
animal  frequently  changing  its  position  or  wandering  about 
in  an  aimless  manner.  Excitement  and  irritability  may 
be  seen  with  a  tendency  to  bite,  although  the  animal  is  not 
aggressive.  In  more  severe  hyperemia,  there  may  be 
spasms  and  convulsions.  The  conjunctiva  is  congested, 
the  pupil  contracted  and  the  expression  vacant  or  staring. 
On  palpation  the  head  feels  warmer  than  normal.  The 
pulse  and  respirations  are  accelerated,  appetite  lost  or  vari- 
able and  the  animal  may  vomit.  These  symptoms  appear 
quite  suddenly  but  do  not  persist  for  long  periods.  They 
may  disappear  in  a  few  hours  or  may  last  as  long  as  three 
or  four  days. 

The  symptoms  of  passive  hyperemia  are  chiefly  those  of 
depression,  although  these  may  alternate  with  periods  of 
excitement. 

Diagnosis.— Except  for  its  shorter  course  and  less  severe 
symptoms,  hyperemia  of  the  brain  cannot  be  differentiated 
from  encephalitis,  the  symptoms  being  identical. 

Prognosis. —The  prognosis  should  be  guarded,  as  even 
apparently  mild  cases  terminate  fatally  through  inflamma- 
tion of  the  brain,  a  common  sequel. 

Treatment.—  Dietetic.—  As  the  animal  will  not  usually 
take  fowl  during  the  acute  stage  and  forcible  feeding  aggra- 
vates the  symptoms,  only  fresh  milk  and  plenty  of  fresh 
water  should  be  offered  at  frequent  intervals.  Keep  the 
patient  in  a  cool,  quiet,  dark  place,  away  from  noise  and 
exciting  influences. 


ANEMIA  OF  THE  BRAIN  437 

Medical.— In  the  early  stages  mild  revulsives  may  be 
administered,  the  object  being  to  divert  the  blood  from  the 
head  to  the  intestinal  tract.  Magnesium  sulphate  (8.0-10.0) 
may  be  given  for  this  purpose  or  pilocarpin  (0.00324-0.0081), 
the  latter  subcutaneously.  If  the  excitement  is  intense  and 
there  are  convulsions,  morphin  sulphate  (0.0324-0.1944)  may 
be  administered  subcutaneously.  If  the  animal  is  depressed, 
narcotics  should  not  be  given,  but  cerebral  stimulants  admin- 
istered: Caffein  citrate  (0.0324-0.1944)  dissolved,  in  normal 
salt  solution  or  distilled  water;  camphor  in  the  form  of  the 
spirit  (0.5-1.0)  given  subcutaneously,  or,  diluted  via  the 
mouth.  Atropin  sulphate  (0.0005-0.001)  is  also  useful  as  a 
cerebral  and  heart  stimulant,  subcutaneously.  If  the  hyper- 
cmia  is  due  to  pressure  from  enlarged  glands  or  tumors,  these 
must  be  removed  according  to  the  rules  of  surgery. 

Surgical.— It  the  animal  is  strong  and  plethoric,  vene- 
section may  be  performed  on  the  saphena  veins  withdrawing 
from  3  to  0  oz.  of  blood.  Cold  applications  to  the  head  in 
the  form  of  cold  packs  or  ice-bags  are  useful  but  only  in  the 
earliest  stages)  and  should  not  be  employed  if  the  animal  is 
depressed.  After  convalescence  is  established,  feed  lightly 
giving  laxative  foods,  as  mush  and  liver  or  oatmeal  and 
milk. 


ANEMIA  OF  THE  BRAIN.     CEREBRAL  ANEMIA. 

Definition.— Anemia  of  the  brain  is  a  condition  in  which 
there  is  a  marked  decrease  from  the  normal  in  the  amount 
of  blood  in  the  brain  and  its  membranes.  It  may  be  acute 
or  chronic. 

Etiology.— Acute  anemia  of  the  brain  may  follow  severe 
hemorrhage,  or  the  too  rapid  withdrawal  of  fluid  from  the 
abdominal  or  thoracic  cavities  as  in  paracentesis.  It  may 
occur  in  thrombosis  of  the  carotid  arteries  or  in  cardiac 
diseases,  as  stenosis  or  valvular  insufficiency. 

Chronic  anemia  of  the  brain  is  seen  in  chronic  constitu- 
tional diseases,  and  in  diseases  affecting  the  blood,  as  general 
anemia  and  leukemia.  Helminthiasis  is  a  common  cause. 


438  DISEASES  OF  THE  BRAIN 

Pathology.— The  brain  and  its  coverings  are  pale  and  the 
vessels  quite  bloodless.  The  cortex  which  is  normally 
pinkish-gray  in  color  is  almost  white  and  on  section  of  the 
brain  mass  appears  to  be  fused  with  the  underlying  white 
mass,  the  line  of  demarcation  being  indistinct. 

Symptoms.— In  acute  anemia  of  the  brain,  the  symptoms 
appear  quite  suddenly  and  vary  from  a  slight  dizziness  to 
complete  insensibility.  The  pulse  is  small  and  weak,  the 
respirations  may  be  slow  and  labored  or  accelerated.  The 
mucous  membranes  of  the  head  are  very  pale.  The  pupil 
of  the  eye  is  dilated.  There  may  be  convulsions  from  which 
the  animal  gradually  recovers  or  these  may  be  followed  by 
death.  The  symptoms  of  chronic  anemia  are  milder  and 
in  cases  which  progress  slowly,  no  symptoms  of  either 
motor  or  psychic  disturbances  occur. 

Prognosis.— Depends  on  the  direct  cause  and  the  possi- 
bility of  its  removal. 

Treatment.— Medical.— In  acute  anemia  of  the  brain,  the 
treatment  is  stimulative.  Any  of  the  cerebral  stimulants, 
as  caffein  citrate  (0.0324-0.1944)  subcutaneously,  alcohol 
(2.0-4.0)  diluted,  if  the  animal  can  swallow,  or  aromatic  spirit 
of  ammonia  (2.0-4.0)  well  diluted. 

Surgical.— Artificial  respiration  and  massage  should  be 
practiced  if  the  patient  requires  it.  Clysters  of  normal  salt 
solution  are  also  beneficial,  or  the  solution  may  be  given 
i  ntraperitoneally . 

Chronic  anemia  of  the  brain  must  be  treated  by  removing 
the  primary  cause  and  treating  the  general  anemia  by  the 
administration  of  tonics,  particularly  the  hematinics  (iron 
and  arsenic  preparations).  Also  prescribe  a  full,  rich  diet. 


MENINGO-ENCEPHALITIS. 

Definition.— This  is  an  inflammatory  process  affecting  the 
brain  and  its  covering  membranes.  It  may  be  suppurative 
or  non-suppurative.  The  writer's  reason  for  combining 
meningitis  and  encephalitis  is,  that  in  practice  these  diseases 
cannot  be  differentiated  during  the  life  of  the  animal,  and 


MENINGO-ENCEPHALITIS  439 

when  one  exists  the  other  is  present  at  least  to  some  extent. 
Furthermore,  the  treatment  is  essentially  the  same. 

Etiology.— Meningo-encephalitis  is  caused  by  practically 
the  same  factors  that  produce  hyperemia  of  the  brain. 
These  are:  Violent  exercise,  excitement,  blows  or  concus- 
sions on  the  head.  Excessive  heat,  direct  sunlight,  etc.,  are 
thermic  causes. 

Infectious  diseases,  as  rabies  and  distemper,  are  at  times 
accompanied  by  meningo-encephalitis  as  are  suppurative  dis- 
eases of  the  auditory  canal  (otitis)  frequently  seen  in  the  rab- 
bit and  occasionally  in  the  dog.  Other  causes  are  metastatic 
emboli  from  infected  internal  organs  as  the  uterus,  lungs, 
heart  (endocarditis)  and  mammary  glands  (tumors). 

Pathology.— In  meningo-encephalitis  lesions  of  various 
size  and  character  may  be  seen,  depending  upon  the  cause, 
and  may  be  formed  anywhere  in  the  brain  or  on  the  mem- 
branes. There  may  be  numerous  inflammatory  areas  or 
perhaps  only  one.  Usually  hemorrhagic,  circumscribed  or 
diffuse  areas  are  noted  either  on  or  within  the  hemisphere, 
or  on  the  cerebral  membranes.  The  color  of  the  areas  varies 
from  a  dark  brown  to  a  greenish-yellow,  depending  on  the 
age  of  the  lesion.  In  those  cases  caused  by  metastatic 
emboli,  suppurative  areas  may  be  found  in  any  part  of 
the  brain  and  are  usually  multiple. 

Symptoms.— As  in  hyperemia  of  the  brain,  there  are  symp- 
toms of  psychic  or  motor  disturbance,  or  both.  Early  there 
is  restlessness  and  timidity,  and  the  dog  may  howl  or  bark 
continuously.  If  unrestrained  the  animal  will  run  or  wander 
about  in  an  aimless  manner  and  frequently  run  against 
objects.  The  head  is  hot,  visible  mucous  membranes  con- 
gested, and  the  eyes  have  a  vacant,  staring  expression.  The 
pupils  may  show  unilateral  contraction  or  dilatation.  While 
most  text-books  state  that  the  pupils  are  contracted,  the 
writer  has  observed  that  in  most  cases  they  are  either  dilated 
or  unequal. 

In  severe  cases  of  meningo-encephalitis,  spasms  and 
convulsions,  followed  by  unconsciousness,  are  observed. 
The  animal  may  gradually  recover  consciousness,  or  may 
die  in  one  of  these  attacks.  When  the  inflammatory  areas 


440  DISEASES  OF  THE  BRAIN 

are  caused  by  metastatic  emboli,  the  temperature  is  ele- 
vated about  two  degrees  and  there  are  symptoms  of  paralysis 
shown,  the  parts  involved  depending  upon  what  portion  of 
the  brain  is  affected.  Deafness  and  blindness  are  not 
uncommon,  showing  involvement  of  the  cranial  nerves. 

Diagnosis.— Meningo-encephalitis,  except  for  its  longer 
course,  cannot  be  differentiated  from  acute  hyperemia  or 
congestion  of  the  brain.  None  but  the  layman  would  con- 
fuse it  with  rabies  (see  Rabies). 

Prognosis.— The  prognosis  is  unfavorable  as  less  than  20 
per  cent,  of  cases  fully  recover.  The  others  usually  die 
within  a  few  days  or  become  chronic  "dummies." 

Treatment.— The  treatment  of  meningo-encephalitis  varies 
in  no  way  from  that  of  hyperemia  of  the  brain. 

CEREBRAL  HEMORRHAGE.  APOPLEXY. 

Definition.— This  is  a  hemorrhage  involving  usually  the 
cortex  of  the  cerebrum,  though  it  may  occur  in  any  portion 
of  the  brain. 

Etiology.— Cerebral  hemorrhage  is  most  frequently  seen 
in  old  dogs  in  which  there  is  some  degenerative  process  in 
the  walls  of  the  afferent  bloodvessels  of  the  brain.  It  is 
also  seen  in  distemper  and  in  the  arteriosclerosis  which  may 
follow  rheumatism.  These  are  predisposing  causes.  The 
direct  causes  are  anything  which  raises  the  blood  pressitte, 
as  excitement,  violent  muscular  exercises,  etc. 

Pathology. — The  hemorrhage  occurs  usually  ,on  the  cere- 
brum from  rupture  of  a  capillary.  If  the  hemorrhage  is 
near  the  surface  the  membrane  covering  the  brain  at  that 
point  will  be  distended  and  the  convolutions  will  be  depressed 
or  flattened. 

The  site  of  the  lesion  may  contain  blood,  hemoglobin  or 
a  serous  fluid,  depending  upon  the  age  of  the  lesion. 

Symptoms.— These  appear  suddenly,  usually  after  play  or 
excitement  and  are  those  of  paresis  or  paralysis.  The  animal 
drops  to  the  floor  or  ground  and  is  convulsed  with  muscular 
spasms.  These  may  pass  off  and  the  animal  will  rise  and 
walk  about  in  an  unsteady  manner,  or  may  lose  conscious- 


TUMORS  OF  THE  BRAIN  441 

ness.  The  conjunctiva  is  reddened,  and  the  heart  beat 
rapid.  The  respirations  are  slow  and  regular  or  they  may 
be  stuporous  and  irregular,  of  the  Cheyne-Stokes'  variety. 
The  temperature  is  about  normal. 

If  the  animal  does  not  die  at  once,  it  is  usually  left  with 
a  partial  or  complete  paralysis,  monoplegic  or  hemiplegic  in 
character,  depending  upon  the  size  and  location  of  the 
hemorrhage.  If  the  hemorrhage  is  small  and  away  from 
the  cortex,  there  will  be  only  slight  convulsions  shown 
followed  by  muscular  incoordination,  the  animal  stumbling 
or  staggering  from  side  to  side  and  falling. 

Diagnosis.— The  sudden  occurrence,  the  history,  the  char- 
acter of  the  respiration  and  the  paralysis  make  the  diagnosis 
not  difficult. 

Prognosis.— The  prognosis  should  be  unfavorable,  only  the 
milder  cases  terminating  favorably. 

Treatment.— Place  the  animal  in  moderately  cool,  well- 
ventilated  quarters  away  from  exciting  influences.  Cold 
applications  should  be  applied  early  to  the  head,  and  if  there 
be  convulsions,  antispasmodics  (morphin,  0.0162-0.1944)  may 
be  administered.  Give  potassium  iodid  (0.1-0.8)  to  resorb 
the  hemorrhagic  exudate,  and  keep  the  bowels  open  with 
mild  purgatives,  such  as  castor  oil  (15.0-40.0).  Later  the 
paralysis  may  be  treated  by  the  administration  of  strychnin 
to  almost  the  toxic  point  (0.00054-0.00216).  The  faradic 
battery  is  also  useful  in  treating  the  paralysis. 

As  this  condition  is  brought  about  by  a  high  blood  pres- 
sure and  is  most  commonly  seen  in  plethoric  animals,  it  is 
well  to  reduce  the  blood  pressure  by  depletion  methods,  such 
as  a  restricted  diet  and  occasional  bleeding  from  the  saphena 
vein,  to  prevent  another  attack. 


TUMORS  OF  THE  BRAIN. 

Tumors  of  the  brain  are  rare  in  small  animals  but  are 
occasionally  observed.  They  may  involve  any  part  of  the 
brain  and  its  covering  membrane,  and  histologically  may  be 
of  any  type. 


442  DISEASES  OF  THE  BRAIN 

The  symptoms  produced  depend  upon  the  location  of  the 
tumor  and  the  degree  of  intracranial  tension.  They  may 
be  those  of  paralysis,  muscular  incoordination,  rolling  or 
turning  movements,  deafness  or  blindness.  Unless  the 
symptoms  indicate  that  the  tumor  is  located  near  the  cortex 
or  involves  the  membranes  covering  the  brain,  treatment, 
which  is  purely  surgical,  should  not  be  attempted. 


CHAPTER    II. 
DISEASES  OF  THE  SPINAL  CORD. 

General  Considerations.  —  Functions  of  the  Core?.— Briefly 
stated,  the  functions  of  the  spinal  cord  are:  (a)  A  con- 
ductor of  nerve  impulses  from  the  intracranial  nerve  centers 
to  the  periphery  (skin  and  muscles),  and  from  the  periphery 
to  the  center;  (6)  it  is  the  great  reflex  center  for  muscular 
coordination,  and  also  contains  in  the  anterior  part  special 
reflex  centers,  which  control  respiration,  the  circulation  and 
deglutition,  and  in  the  lumbar  portion  are  the  centers  for 
defecation,  micturition,  etc. 

Examination.— The  cord,  like  the  brain,  cannot  be  exam- 
ined directly  on  account  of  its  sheltered  position  within 
the  vertebral  canal,  but  diseases  of  the  cord  can,  in  a  general 
way,  be  recognized  by  examining  its  functions.  This  is 
done  by  essentially  the  same  methods  as  are  employed  in 
making  an  examination  of  the  brain. 

It  is  difficult  in  some  cases  to  differentiate  between  diseases 
affecting  the  cord  and  those  affecting  the  brain,  but  since 
the  cord  is  the  seat  of  the  reflex  action,  diseases  affecting 
it  will,  in  many  cases,  destroy  one  or  more  of  the  reflex 
arcs  depending  upon  what  particular  part  of  the  cord  the 
lesion  occurs  in.  Therefore,  all  reflex  action  will  be  absent 
or  modified  posterior  to  the  lesion.  This,  together  with 
the  fact  that  in  diseases  or  lesions  involving  the  cord  alone 
no  psychic  disturbances,  as  a  rule,  are  present,  will  serve 
to  differentiate  between  them. 

MENINGOMYELITIS. 

Definition.— This  is  an  inflammation  of  the  spinal  cord  and 
its  covering  membranes.  It  is  quite  common  in  the  dog  and 
rabbit  but  rare  in  the  other  small  animals. 


444       DISEASES  OF  THE  SPINAL  CORD 

Etiology.  —  Mechanical. — Common  causes  of  meningo- 
myelitis  are  traumatic  injuries,  such  as  blows  in  the  region 
of  the  back  or  loins,  being  run  over  by  vehicles,  etc. 

Infectious.— It  is  also  seen  during  or  following  the  infec- 
tious diseases  as  distemper,  rabies,  pyemia,  etc.,  and  abscesses 
in  the  region  of  the  spine,  the  pus  burrowing  between  the 
vertebrae  and  attacking  the  meninges  and  cord  occasion  it. 

Pathology . —The  membranes  covering  the  cord  are  some- 
what thickened  and  show  either  diffuse  or  circumscribed 
areas  of  inflammation,  and  may  be  adherent  to  the  cord  itself. 
In  other  cases,  depending  on  the  cause,  abscesses  may  be 
found  involving  both  the  membranes  and  the  cord.  If  the 
condition  is  due  to  traumatic  causes,  the  vertebrae  may  be 
broken  or  splintered  with  some  portion  pressing  on  the 
cord.  The  spinal  fluid  is  increased  in  quantity  and  may  be 
purulent  in  character. 

Symptoms. —The  symptoms  of  meningomyelitis,  unless  of 
traumatic  origin,  appear  gradually  and  become  more  severe 
as  the  disease  progresses.  They  may  vary  from  slight  motor 
and  sensory  disturbances  to  complete  paralysis.  There  is 
slight  twitching  of  the  extremities  which  is  usually  the  first 
symptom  noted. 

Disturbances  of  sensation  are  frequently  observed  as 
hyperesthesia,  the  animal  showing  pain  when  handled  or 
even  when  stroked  with  the  hand.  Symptoms  of  paralysis 
are  seen  later,  except  when  due  to  severe  traumatic  causes, 
when  the}'  may  be  the  first  and  only  symptoms  shown. 
The  patient  has  a  staggering  gait,  sways  from  side  to  side 
when  walking  and  finally  drags  its  hind  limbs.  When 
placed  on  its  feet,  it  will  drop  sideways  on  its  hind  quarters. 

If  the  lesion  in  the  cord  is  far  forward,  the  anterior  limbs 
may  also  be  involved.  If  in  the  cervical  region,  however, 
death  usually  follows  suddenly  from  respiratory  arrest. 

The  sphincters  of  the  anus  and  urinary  bladder  are 
usually  involved  causing  the  feces  and  urine  to  pass  involun- 
tarily, though  there  is  usually  constipation.  Progressive 
paralysis  indicates  tumors  pressing  on  the  cord.  If  only 
the  membranes  covering  the  cord  are  involved,  the  spinal 
reflex  is  present  and  may  be  exaggerated.  If  a  portion  of 


CONCUSSION  OF  THE  SPINAL  CORD  445 

the  cord  itself  is  destroyed,  reflex  movement  is  absent 
posterior  to  the  lesion.  Consciousness  is  not  disturbed. 

Diagnosis.— It  is  usually  not  difficult  to  differentiate 
between  diseases  of  the  spinal  cord  and  those  of  the  brain, 
but  to  state  definitely  the  character  of  the  lesion  and  its 
exact  location  should  not  be  attempted.  In  diseases  of  the 
nervous  system  it  is  generally  sufficient  to  state  whether 
the  brain  or  cord  is  affected. 

Prognosis. — In  meningomyelitis,  as  in  other  diseases  of 
the  brain  and  cord,  the  prognosis  is  generally  unfavorable, 
only  a  small  percentage  recovering. 

Treatment.— In  the  early  stages  give  laxatives,  as  mag- 
nesium sulphate  (8.0-12.0)  or  castor  oil  (15.0-40.0)  and 
apply  counterirritants  to  the  spine. 

The  faradic  battery  is  useful  in  treating  the  paralysis,  or 
strychnin  almost  to  the  point  of  intoxication.  lodid  of 
potassium  may  be  given  to  resorb  the  exudate. 

The  animal  should  be  placed  under  good  hygienic  sur- 
roundings and  kept  clean  and  dry. 

CONCUSSION  OF  THE  SPINAL  CORD. 

Injuries  of  the  Spinal  Cord. 

Etiology.— This  condition  occurs  quite  frequently  in  the 
dog  and  cat  from  a  variety  of  causes.  These  animals  are 
subjected  to  extreme  violence  often  by  being  run  over  by 
fast  moving  vehicles,  by  penetration  of  the  spinal  canal 
by  sharp  or  blunt  objects,  or  from  the  animal  falling.  Many 
cases  such  as  described  result  in  fracture  of  the  vertebra1 
with  direct  injury  to  the  cord.  Extreme  muscular  exertion 
combined  with  diseases  of  the  bones  (fragilitas  ossium)  will 
result  in  fracture  and  injury  to  the  cord.  The  injuries 
to  the  cord  with  fracture  of  the  vertebra*  often  lead  to 
hemorrhage  between  the  membranes  or  in  the  spinal  cord 
proper.  Puncture  into  the  spinal  canal  as  has  been  practiced 
in  certain  cases,  frequently  terminates  in  edema  of  the  cord 
and  membranes  from  the  irritation,  or  hemorrhage  into  the 
spinal  canal. 


446  DISEASES  OF  THE  SPINAL  CORD 

Pathogenesis. — As  soon  as  the  injury  occurs,  and  the  cord 
either  crushed  or  compressed  by  extravasated  blood  or 
serum,  it  loses  its  conductivity  in  proportion  to  the  degree 
of  the  injury  and  compression.  The  conductivity  of  the 
cord  may  thus  be  either  partially  or  entirely  lost  and  the 
function  of  the  nerves  will  be  partially  or  completely 
destroyed  in  the  area  involved.  In  minor  injuries  with 
simply  edema  of  the  membranes  or  cord  the  development 
is  gradual  and  the  degree  of  involvement  very  slight. 

Symptoms.— The  symptoms  of  compression  or  injury  to 
the  spinal  cord  will  depend  upon:  (a)  The  location  of  the 
injury  or  portion  of  the  cord  affected;  (6)  the  degree  of 
compression  or  destruction  of  the  cord.  When  the  spinal 
cord  is  compressed  or  crushed  in  the  cervical  region  the 
animal,  as  a  rule,  does  not  live  over  a  few  minutes  or  hours. 
Complete  paralysis  is  observed  posterior  to  the  point  of 
injury.  The  patient  may  be  able  to  bring  the  muscles  of 
the  head  into  action  for  a  short  period  preceding  death. 
In  cases  of  lesser  injury  or  compression  the  symptoms  are 
not  so  pronounced  and  the  patient  may  be  able  to  move 
certain  groups  of  muscles.  If  the  compression  is  due  to 
edema  of  the  membranes  or  hemorrhage  into  the  cord  or 
canal  the  symptoms  are  milder  and  gradually  disappear 
in  the  course  of  a  few  days  or  weeks. 

Complete  destruction  of  the  cord  posterior  to  the  cervical 
enlargement  will  produce  paralysis  and  complete  loss  in 
sensation  in  the  limbs,  tail  and  body.  This  is  noticeable 
in  the  respiration  as  the  ribs  remain  fixed  and  the  respiratory 
movements  are  confined  to  the  diaphragm. 

There  may  be  retention  of  urine  and  feces,  or  they  may 
be  voided  involuntarily. 

When  the  dorsal  portion  of  the  spinal  cord  is  affected 
there  will  be  paralysis  of  the  posterior  part  of  the  body. 
In  slight  injury  or  compression  there  may  be  only  inco- 
ordination  of  movement  from  the  point  of  injury. 

Compression  or  destruction  of  the  anterior  part  of  the 
lumbar  segment  results  in  paralysis  and  anesthesia  of  the 
hind  limbs,  tail  and  muscles  of  the  croup.  When  the 
injury  is  in  the  middle  or  posterior  portion  of  the  lumbar 


CONCUSSION  OF  THE  SPINAL  CORD  447 

segment  the  symptoms  will  be  modified  somewhat  owing 
to  the  injury  of  the  sacral  segment  which  results  in  paralysis 
of  the  area  supplied  by  the  sciatic  nerve.  The  sphincters 
of  the  bladder  and  anus  respectively  will  be  paralyzed  and 
urine  and  feces  discharged  involuntarily. 

When  the  injury  occurs  in  small  animals  spasms  of  adja- 
cent muscles  will  be  observed.  This  is  due  no  doubt  to  the 
injury  producing  stimulation  to  the  nerve  roots.  On 
examination  of  the  patient  the  temperature  is  often  elevated, 
or  it  may  be  subnormal  if  the  sphincters  are  relaxed  and  the 
thermometer  inserted  in  the  rectum.  Palpation  over  the 
region  of  injury  will  cause  the  animal  intense  pain  and  fre- 
quently convulsions  or  spasms.  Swelling  is  often  present 
and  crepitation  may  be  detected.  Abnormal  movement  of 
the  vertebrae  involved  can  be  determined  in  the  cervical  and 
lumbar  segments. 

Diagnosis.— This  is  accomplished  only  after  careful  exam- 
ination and  consideration  of  the  -parts  paralyzed.  The 
determination  of  the  degree  of  injury  is  often  very  difficult. 
There  might  be  a  complete  paralysis  resulting  from  edema 
and  hemorrhage  greatly  resembling  cases  of  destruction 
of  the  cord.  However,  the  history  of  the  case  will  assist  in 
the  differential  diagnosis. 

Course.— In  complete  destruction  of  the  cord  in  the 
cervical  segment  death  may  occur  in  a  few  moments  or 
may  be  delayed  for  several  hours.  Should  there  be  hemor- 
rhage only  and  partial  paralysis  the  patient  may  live  for 
several  days  and  some  will  make  a  complete  recovery.  In 
involvement  of  the  dorsal  and  lumbar  segments  the  course 
will  depend  upon  the  degree  of  injury.  In  small  animals  they 
may  live  for  several  weeks  or  months. 

Prognosis.— A  definite  prognosis  is  often  difficult  to  arrive 
at  on  account  of  the  impossibility  to  determine  the  degree 
of  injury  in  all  cases.  When  there  is  evidence  of  complete 
destruction  of  the  cord  the  case  is  hopeless.  In  cases  of 
hemorrhage  or  edema  most  patients  will  make  a  complete 
recovery.  At  best  the  prognosis  should  be  held  in  reserve 
until  the  exact  condition  can  be  determined. 


448  DISEASES  OF  THE  SPINAL  CORD 

Treatment.— No  treatment  will  be  of  any  value  where  the 
spinal  cord  is  destroyed.  If  crepitation  is  present  and 
distinct  separation  and  movement  between  the  involved 
vertebrae  are  detected  it  is  advisable  to  destroy  the  animal. 
If  in  doubt  in  regard  to  the  actual  condition  the  patient 
should  be  given  a  soft  bed  and  quiet  place.  Good  nourish- 
ing food  (meat,  milk)  and  gentle  massage  over  the  region 
injured  will  assist  in  the  resorption.  In  the  secondary 
stages  small  doses  of  strychnin  sulphate  (0.001)  daily  and 
electricity  have  proved  to  be  beneficial. 

COMPRESSION  OF  THE  SPINAL  CORD. 

Definition.— A  condition  in  which  there  is  more  or  less 
disturbance  in  the  function  of  the  spinal  cord  from  pressure 
by  exostosis,  tumors,  abscesses,  parasites,  etc. 

Etiology.— Various  diseased  conditions  will  produce  com- 
pression of  the  cord.  The  following  are  most  common  and 
important:  (a)  In  the  dog  degeneration  of  the  interverte- 
bral  disks  in  which  there  is  distortion  and  enlargement 
projecting  into  the  spinal  canal,  narrowing  its  lumen  and 
causing  compression  of  the  cord.  This  condition  has  been 
observed  in  certain  breeds  of  dogs  and  in  Belgian  hares. 
The  cause  is  no  doubt  injury  to  the  disks  by  extreme  mobil- 
ity or  concussion.  (/;)  Ossification  of  the  intervertebral 
disks.  This  is  found  in  older  animals,  mainly  in  old  dogs. 
It  may  exist  in  an  individual  disk  or  what  is  more  common 
a  number  of  them  will  be  affected  producing  rigidity  of  the 
vertebral  column.  The  enlargements  resulting  from  the 
ossification  project  into  the  spinal  canal  directly  compres- 
sing the  cord.  The  condition  usually  begins  in  the  most 
mobile  portion  of  the  vertebral  column.  Fracture  of  the 
vertebra?  without  destruction  of  the  cord  may  bring  about 
a  similar  condition  upon  union  of  the  fractured  portions. 
The  new  bone  formation  projects  into  the  spinal  canal. 
(c)  Tumors.  In  the  dog  sarcomas  may  cause  compression 
of  the  cord  by  the  tumor  developing  in  close  proximity  to 
the  vertebral  column  and  the  growth  extending  through  the 
intervertebral  foramina.  Other  growths  rarely  produce  this 


COMPRESSION  OF  THE  SPINAL  CORD  449 

condition,  (d)  A  few  cases  have  been  observed  in  dogs  and  in 
rabbits  in  which  Echinococcus  granulosus  cysts  produced 
local  pressure  on  the  spinal  cord,  (e)  Abscesses  developing 
in  the  spinal  canal  are  rare,  but  when  found  near  the  verte- 
bral column,  the  pus  may  burrow  in  between  the  inter- 
vertebral  disks  producing  infection  resulting  in  edema  and 
inflammation. 

Pathogenesis.— Any  of  the  conditions  enumerated  may 
lead  to  a  reduction  in  the  lumen  of  the  spinal  canal.  The 
degree  of  injury  or  compression  of  the  cord  will  depend 
upon  the  character  of  the  course  and  the  point  of  involve- 
ment of  the  vertebral  column. 

Symptoms.— The  rigidity  of  the  spine  and  the  careful  way 
in  which  the  animal  lies  down  and  gets  up  are  somewhat 
characteristic.  Dogs  exhibit  considerable  pain  on  moving 
the  spinal  column  by  whining,  crying,  etc.  In  movement 
the  animal  is  very  cautious  and  often  if  recumbent  refuses 
to  arise  when  called.  Examination  of  the  patient  reveals 
the  rigid  condition  of  the  spine  and  the  fixation  of  the 
muscles  of  the  back.  Forced  movement  of  the  vertebra? 
induces  severe  pain.  Paralysis  gradually  develops  posterior 
to  the  point  of  compression;  sensation  is  partially  or  com- 
pletely destroyed,  and  involuntary  passage  of  urine  and 
feces  follows  from  paralysis  of  the  sphincter  muscles  con- 
cerned. 

Diagnosis.— An  early  diagnosis  is  often  difficult  owing  to 
the  gradual  development  of  the  primary  condition.  A 
careful  examination  of  the  vertebral  column,  its  rigidity, 
evidence  of  pain  on  movement,  will  assist  in  the  diagnosis. 
It  may  be  confused  with  muscular  rheumatism. 

Prognosis.— This  must  be  considered  unfavorable  in  all 
cases.  Recovery  is  very  rare. 

Treatment.— Treatment  is  practically  impossible.  Oper- 
able tumors,  when  its  cause,  may  be  removed  surgically. 
Abscesses  may  be  opened  and  drained,  but  owing  to  the 
complicating  infection  little  can  be  expected  in  the  way  of 
recovery  or  even  improvement.  No  internal  treatment  has 
proved  of  any  value.  Small  doses  of  potassium  iodid  may 
be  tried  in  the  milder  cases. 
29 


CHAPTER  III. 

DISEASES  OF  THE  PERIPHERAL  NERVOUS 
SYSTEM. 

INJURIES  OF  THE  PERIPHERAL  NERVES. 

Small  animals  are  subjected  to  a  variety  of  injuries  which 
may  involve  the  individual  nerves  or  nerve  endings,  such 
as  bruises  of  the  muscles,  in  which  the  nerve  is  crushed 
against  the  bones,  or  between  muscles,  or  stretched  or  torn 
or  the  nerve  is  cut  by  sharp  objects  which  is  more  frequent. 

PRESSURE  UPON  THE  PERIPHERAL  NERVES. 
COMPRESSION. 

Most  frequently  compression  results  from  neoplastic 
formations  (sarcomas,  neuromas),  from  hemorrhagic  extrav- 
asations, serous  effusions  into  the  tissues,  enlargement  of 
lymph  glands,  fractures  of  bones  or  abscess  formation. 

Neuritis  undoubtedly  occurs  in  small  animals,  particu- 
larly in  dogs,  and  may  result  from  a  variety  of  causes. 
Chilling  or  subjection  to  extremes  of  temperature  is 
perhaps  most  productive  of  the  condition.  The  inflam- 
mation resulting  is  subsequently  followed  by  paralysis  in 
a  number  of  cases. 

PARALYSIS  OF  THE  PERIPHERAL  NERVES. 

The  following  paralyses  of  peripheral  nerves  have  been 
noted : 

Facial  Nerve.— Dogs  and  rabbits  are  most  often  affected. 

Etiology.— (a)  Traumatic  influences  play  an  important  role 
in  the  unilateral  form  of  facial  paralysis  (monoplegia  facialis) 
by  injuring  the  nerve  at  the  point  where  it  goes  around  the 
maxillary  bone'.  (6)  Neoplasms  in  the  parotid  region  involve 


PARALYSIS  OF  THE  PERIPHERAL  NERVES       451 

the  nerve  and  destroy  its  function  either  by  compression 
or  direct  growth  into  it.  (c)  Inflammation  of  the  middle 
ear,  caries  of  the  petrous  portion  of  the  temporal  bone,  and 
tumors  in  the  base  of  the  brain  often  produce  it.  (d)  Dis- 
temper (nervous  form)  producing  an  encephalitis  will  often 
result  in  paralysis  of  the  facial  nerve,  (e)  Exposure  to  cold, 
such  as  hunting  dogs,  or  retrievers  in  which  the  surface  of 
the  body  is  suddenly  subjected  to  the  extreme  temperature. 

A  bilateral  facial  paralysis  (diplegia  facialis)  is  usually 
of  central  origin. 

Symptoms.— In  case  the  entire  nerve  with  all  its  branches 
is  paralyzed  there  will  be  paralysis  of  the  ear,  eyelids  and 
lips  on  the  side  affected.  The  ear  will  droop,  and  the  animal 
is  unable  to  elevate  it  when  called  or  excited.  The  eyelids 
hang  downward  and  are  immovable.  The  lip  will  be  found 
soft,  flabby  and  will  not  react  to  normal  stimuli.  When 
these  symptoms  are  present  the  lesion  is  central.  On  the 
other  hand,  should  there  be  a  paralysis  of  the  lips  only, 
it  would  indicate  a  peripheral  form  of  facial  paralysis. 
Paralysis  of  the  facial  nerve  arising  from  the  central  nervous 
system  may  have  associated  with  it  paralysis  of  other  cranial 
nerves.  This  would  complicate  the  symptoms. 

Diagnosis.— The  symptoms  are  characteristic.  A  differ- 
ential diagnosis  should  be  made  between  central  facial 
paralysis  and  the  peripheral  form.  This  can  be  easily 
determined  in  most  cases  by  noting  the  extent  of  the  paralysis. 

Prognosis.— When  there  is  complete  paralysis  of  central 
origin  it  is  considered  unfavorable.  However,  if  the  con- 
dition has  only  temporarily  affected  the  nerve  the  animal 
will  recover.  The  exact  condition  of  the  nerve  is  impossible 
to  determine.  In  the  peripheral  form  the  condition  of  the 
nerve  at  the  point  of  injury  is  important.  When  not 
destroyed  the  prognosis  is  favorable. 

Treatment.  — In  the  peripheral  form  due  to  injury  or  chill- 
ing, the  symptoms  usually  disappear  quite  promptly.  The 
parts  should  be  massaged  thoroughly  and  the  electric 
current  applied  daily  over  the  region.  Stimulating  lini- 
ments massaged  into  the  tissues  are  recommended  (soap 
liniment,  camphor  liniment,  white  liniment).  If  tumors 


452        DISEASES  OF  THE  PERIPHERAL  NERVES 

or  abscesses  are  present  they  should  be  operated  at  once, 
care  being  taken  to  avoid  injuring  the  nerve.  In  the  central 
form  nerve  stimulants  (strychnin  sulphate  0.001  daily),  or 
electricity  should  be  employed.  Usually  in  the  course  of 
ten  days  to  two  weeks  improvement  will  be  noticed.  If 
after  one  month  to  six  weeks  no  improvement  is  noted  the 
chances  are  that  the  nerve  trunk  has  been  completely 
destroyed  and  further  treatment  is  useless.  Spasm  of  the 
muscles  supplied  by  the  facial  nerve  occurs  occasionally, 
especially  in  dogs,  no  doubt  due  to  the  infection  from  dis- 
temper producing  irritation  to  the  nerve.  It  may  also  occur  in 
meningitis  and  encephalitis.  When  present  the  condition  is 
characterized  by  clonic  convulsions  of  the  muscles  supplied 
by  the  nerve.  Sedatives  would  be  indicated  to  reduce  the 
irritation. 

Trigeminal  Nerve.— Paralysis  of  this  nerve  is  observed 
most  often  in  dogs. 

Etiology.  — (a)  Rabies  produces  the  greatest  number  of 
cases.  Therefore,  all  cases  of  trigeminal  paralysis  should 
be  handled  with  caution  until  the  exact  cause  is  known.  (6) 
Occurs  in  some  cases  from  distemper,  (c)  Inflammation  of 
the  brain  and  concussion  of  the  brain  also  cause  it.  (rf) 
Injuries  in  which  the  motor  branch  is  pressed  or  crushed. 
This  happens  not  uncommonly  in  dogs  from  extreme  open- 
ing of  mouth,  or  carrying  large  heavy  objects  in  the  mouth. 
(e)  Tumor  formations,  such  as  sarcomata  in  close  proximity 
to  the  nerve,  or  abscesses.  These  conditions  may  either 
injure  the  nerve  directly  or  by  external  pressure.  (/)  Rheu- 
matic conditions  involving  the  muscles  supplied  by  the  nerve. 
(g)  Neoplasms  at  the  base  of  the  cranium  (angioma) . 

Symptoms. — The  most  pronounced  symptom  is  dropping 
of  the  lower  jaw,  the  mouth  remaining  open  constantly.  In 
such  cases  rabies  should  be  suspected.  In  unilateral  paralysis 
the  animal  may  be  able  to  close  the  mouth  and  masticate  on 
one  side.  If  all  three  branches  of  the  nerve  are  paralyzed 
mastication  and  sensibility  are  lost.  In  case  any  individual 
branch  of  the  nerve  is  paralyzed  that  part  supplied  by  that 
branch  only  will  be  affected.  When  the  mouth  remains 
open  the  tongue  will  protrude,  become  dry  and  discolored. 


PAltALYSIS  OF  THE  PERIPHERAL  NERVES      453 

Saliva  is  usually  profuse  and  flows  from  the  open  mouth. 
Attempts  at  eating  and  drinking  fail.  Food  is  swallowed 
when  placed  hack  in  the  mouth. 

Diagnosis. — The  only  difficulty  in  diagnosis  is  to  determine 
the  cause  of  the  paralysis.  The  symptoms  are  so  charac- 
teristic that  the  actual  condition  is  easily  recognized.  A 
differential  diagnosis  should  be  made  to  determine  whether 
or  not  the  animal  is  affected  with  rabies.  The  general  con- 
dition of  the  animal,  disturbance  in  swallowing,  change  of 
voice  and  paralysis  in  the  posterior  part  of  the  body  in 
rabies  are  indicative. 

Prognosis.— Should  the  condition  result  from  trauma  then 
the  prognosis  is  considered  favorable,  otherwise  unfavorable. 

Treatment.  — If  the  paralysis  is  the  result  of  rabies  no 
treatment  should  be  attempted.  In  cases  due  to  other 
causes,  give  nourishing  food  (milk,  chopped  meat).  This 
is  best  done  either  by  placing  the  food  well  back  into  the 
mouth,  or  by  the  use  of  a  stomach-tube.  Massage  the 
muscles  thoroughly,  using  at  the  same  time  a  stimulating 
liniment  (soap  liniment).  Electricity  may  also  be  tried, 
(live  internally  tincture  nux  vomica  (0.3-0.7)  or  strych- 
nin sulphate  (0.001)  daily.  Spasms  of  the  muscles  supplied 
by  the  trigeminal  nerve  are  observed  in  tetanus  and  in  some 
cases  of  the  nervous  form  of  distemper.  The  muscles 
are  either  rigid  as  in  tetanus,  or  contracting  and  relaxing 
rapidly  as  in  some  cases  of  distemper.  Nerve  sedatives 
should  be  used  to  control  the  spasms.  Tetanus  antitoxin 
and  distemper  serum  respectively  may  be  employed,  depend- 
ing on  the  condition  present. 

Auditory  Nerve.  Etiology.— The  true  nerve  of  hearing 
(cochlear  nerve)  is  not  frequently  paralyzed.  However,  it 
may  be  paralyzed  from  a  congenital  defect  or  inflammatory 
changes  within  the  internal  ear,  or  from  diseases  affecting 
the  medulla  oblongata.  Paralysis  of  the  vestibular  nerve  is 
very  commonly  observed  in  dogs,  rabbits,  fowls  and  pigeons. 
In  practically  all  cases,  however,  it  is  the  result  of  inflam- 
matory changes  within  the  middle  and  inner  ear.  These 
changes  may  result  from  chicken  pest,  cholera,  epitheliosis, 
contagious  rhinitis  (rabbit),  or  distemper.  Causes  of 


454          DISEASES  OF  THE  PERIPHERAL  NERVES 

minor  importance  are:  Concussion  of  the  brain,  hemor- 
rhages in  the  middle  ear,  or  caries  of  the  petrous  portion 
of  the  temporal  bone. 

Symptoms.— Deafness  is  the  pronounced  symptom  of 
paralysis  of  the  cochlear  nerve.  If  bilateral  and  complete 
the  animal  will  be  totally  deaf.  In  vestibular  paralysis, 
when  unilateral,  the  patient  will  assume  a  peculiar  attitude 
holding  the  head  downward  and  toward  the  normal  side. 
In  chickens  the  head  is  rotated  to  the  degree  that  the  comb 
will  rest  on  the  ground.  In  dogs  and  rabbits  rolling  move- 
ments are  very  prominent  symptoms.  This  is  so  marked 
in  some  cases  that  it  is  impossible  to  hold  the  animal.  The 
least  irritation  or  disturbance  will  cause  them  to  show  it. 
Rolling  movements  always  take  place  toward  the  normal 
side.  Attempts  at  walking  are  difficult  but  if  they 'succeed 
will  travel  in  circles,  often  falling  down  and  rolling  over 
and  over.  The  eyelids  are  often  closed  and  the  eyeball 
assumes  an  abnormal  position.  In  case  of  bilateral  vestib- 
ular paralysis,  the  head  drops  down  and  the  muscles  of 
the  neck  are  limp. 

Diagnosis.— This  should  not  be  difficult,  as  the  symptoms 
of  deafness  are  easily  manifest  and  the  peculiar  movements 
of  the  animal  in  vestibular  paralysis  are  characteristic. 

Prognosis.— Should  be  considered  unfavorable  except  when 
due  to  injuries. 

Treatment.— If  due  to  injuries  the  animal  should  be  kept 
quiet  and  if  necessary  fed  artificially  in  order  to  maintain 
its  general  condition.  The  ears  should  always  be  exam- 
ined to  determine  their  condition  (disease  or  parasites). 
Pigeons,  when  affected,  are  isolated  and  the  premises  dis- 
infected to  guard  against  contagious  meningitis.  Internal 
administration  of  magnesium  sulphate  or  castor  oil  as  a 
laxative  is  advised.  No  treatment  can  be  applied  direct 
to  the  seat  of  the  condition. 

Radial  Nerve.— Paralysis  of  this  nerve  occurs  occasionally 
in  the  dog  and  cat. 

Etiology.  — (a)  On  account  of  the  position  of  the  radial 
nerve  it  is  easily  injured  by  traumatism.  Animals  struck 
by  objects,  falling,  jumping,  etc.,  very  commonly  injure 


PARALYSIS  OF  THE  PERIPHERAL  NERVES       455 

the  nerve  with  resulting  partial  or  complete  paralysis  which 
may  be  temporary  or  permanent.  (6)  May  follow  muscular 
rheumatism  or  subjection  to  cold,  (c)  Follows  infectious 
diseases,  such  as  distemper  in  dogs  and  cats,  (d)  Has  been 
observed  from  injury  to  the  spinal  cord,  (e)  Tumors  and 
abscesses  in  the  muscles  may  bring  about  at  least  a  tempo- 
rary radial  paralysis. 

Symptoms.— The  radial  nerve  controls  the  muscles  that 
extend  the  forelimb;  therefore  the  most  prominent  symp- 
tom is  inability  to  carry  the  limb  forward.  The  joints  are 
extended  below  the  elbow  and  flexed  above  that  point.  The 
animal  in  moving  forward  drags  the  toe  on  the  ground  and 
weight  cannot  be  supported  owing  to  the  difficulty  of  prop- 
erly placing  the  limb  in  the  normal  position.  Some  weight 
will  be  supported  on  the  limb  when  it  is  placed  in  position. 
The  degree  of  disturbance  will  depend  upon  whether  the 
paralysis  is  complete  or  partial.  Local  examination  reveals 
absence  of  inflammatory  changes.  There  is  usually  a 
normal  degree  of  sensitiveness  in  the  skin. 

Diagnosis.— A  careful  examination  should  be  made  in 
the  dog  for  they  are  inclined  to  favor  the  limb  in  the  least 
disturbance.  However,  in  many  cases  of  injuries,  the  limb 
will  be  carried  from  the  ground  while  in  this  case  it  will  be 
just  the  opposite,  dragged  on  the  ground.  Examine  for 
thrombosis  of  the  axillary  arteries. 

Prognosis.— The  larger  number  of  cases  recover.  This  is 
explained  in  that  most  cases  result  from  injuries  which  do 
not  seriously  disturb  the  structure  of  the  nerve.  Few  cases 
will  be  permanent. 

Treatment.—  Massage  the  muscles  and  stimulate  them  by 
the  use  of  the  electric  current.  Nerve  tonics  may  also  be 
given.  If  no  improvement  is  apparent  in  ten  days  to  two 
weeks  the  case  should  be  considered  unfavorable. 

Brachial  Plexus.— Paralysis  of  the  brachial  plexus  occurs 
most  commonly  in  the  dog  and  cat. 

Etiology.— The  majority  of  cases  result  from  injury,  from 
falling  or  jumping  from  great  heights.  Fracture  of  bones 
adjacent  to  the  plexus  resulting  in  injury  will  produce  it. 
Tumor  formations  and  abscesses  in  the  axillary  region  are 
also  causes. 


450        DISEASES  OF  THE  PERIPHERAL  NERVES 

Symptoms.— The  most  prominent  symptom  is  a  limp, 
lifeless  condition  of  the  limb  unable  to  support  any  weight. 
Sensation,  as  a  rule,  is  lost  in  the  entire  limb.  If  the  paralysis 
is  partial  only,  the  symptoms  will  be  less  prominent. 

Prognosis.— Most  cases,  inasmuch  as  they  are  due  to 
injuries,  recover  completely  in  the  course  of  a  few  weeks. 

Treatment.— Massage  and  nerve  stimulants  are  useful. 
Keep  the  animal  well  nourished. 

Sciatic  Nerve.— Etiology.  — (a)  Falling  from  heights  and 
jumping.  (6)  Wounds  and  direct  injuries  to  the  nerve,  (c) 
Infectious  disease^  (distemper),  (d)  Tumors  and  abscesses 
in  contact  with  the  nerve. 

Symptoms.— There  will  be  paralysis  of  the  biceps  femoris, 
the  semitendinosus  and  the  muscles  below  the  stifle  joint. 
In  the  dog  the  limb  will  hang  relaxed  and  during  forward 
movement  the  toe  is  dragged  on  the  ground.  Cases  will  be 
seen  where  the  hair  and  skin  are  abraded  from  the  anterior 
surface  of  the  foot.  There  may  be  loss  of  sensation  below 
the  stifle  joint.  In  bilateral  sciatic  paralysis  it  resembles 
lumbar  paralysis  to  a  certain  degree.  A  differentiation 
should  be  made.  Atrophy  of  the  affected  muscles  will  soon 
be  noticeable. 

Prognosis. — If  due  to  injuries  it  is  favorable,  provided  the 
nerve  is  not  completely  destroyed. 

Treatment.— Massage  and  employ  nerve  stimulants.  Pro- 
tect the  feet  from  injury,  give  nourishing  food  and  use 
the  electric  current. 

Paralysis  of  other  nerves  is  occasionally  seen  but  is  of 
minor  importance. 


CHAPTER  IV. 
FUNCTIONAL  NERVOUS  DISEASES. 

VERTIGO.     MEGRIM. 

Definition. —A  condition  characterized  by  dizziness  and 
general  disturbance  of  equilibrium  (swooning).  In  small 
animals  it  is  not  very  commonly  observed,  except  in  dogs, 
rabbits  and  pigeons. 

Etiology. — In  these  animals  the  condition  is  very  seldom 
found  as  a  primary  disease.  It  is  usually  secondary  to  other 
diseases  which  it  may  follow. 

(a)  Diseases  of  the  brain,  such  as  hyperemia,  acute  and 
chronic,  or  encephalitis,  often  produce  the  symptoms  of 
vertigo.  (6)  Tumors,  hemorrhage  into  the  brain  or  mem- 
branes, concussion  of  the  brain,  or  emboli  of  some  of  the 
cerebral  bloodvessels  may  also  produce  it.  (c)  Defects  of 
vision,  or  irregular  lighting  in  which  too  sudden  change 
takes  place  in  the  accommodation  of  the  eye,  have  been 
cited  as  causes,  (d)  Diseases  of  the  middle  or  inner  ear. 
(e)  Sudden  change  in  the  circulation  of  the  blood  in  which 
there  is  cerebral  anemia.  Tight  collars  may  produce  the  con- 
dition, or  the  dog  pulling  steadily  on  the  leash  may  bring 
it  about.  (/)  Reflex  conditions  from  the  intestinal  tract 
(parasites  or  intestinal  catarrh),  (</)  From  poisoning,  such 
as  ptomains,  certain  poisonous  plants,  or  overdoses  of  alcohol 
and  other  narcotics.  (/?)  Pigeons  are  sometimes  affected  by 
a  contagious  or  infectious  disease  having  as  its  most  promi- 
nent symptom  vertigo.  Large  numbers  may  be  affected  at 
the  same  time. 

Symptoms.— The  early  indication  of  vertigo  is  charac- 
terized by  a  sudden  staggering  gait.  The  animal  falls 
down,  becomes  unconscious.  It  remains  in  this  position 
quietly  for  a  few  moments,  arises  and  soon  assumes  its 
normal  condition.  The  individual  attack  is  usually  of 


458  FUNCTIONAL  NERVOUS  DISEASES 

short  duration,  from  two  to  ten  minutes.  The  time  elaps- 
ing between  the  attacks  is  variable.  The  prodromal  symp- 
toms are  anxiety,  staring  expression,  increased  respiratory 
movements,  and  sometimes  slight  twitching  of  the  muscles. 
When  occurring  in  pigeons  the  number  affected  should  be 
noted  to  determine  whether  or  not  an  infectious  disease  is 
causing  it. 

Diagnosis.— A  differential  diagnosis  should  be  made  be- 
tween vertigo  and  epilepsy.  The  main  differential  feature 
is  the  absence  of  convulsions  in  vertigo.  The  symptom 
vertigo  is  not  so  difficult  to  determine,  but  its  causes  may 
remain  quite  obscure. 

Prognosis.— Should  not  be  considered  very  favorable  as  the 
cause  is  hard  to  determine.  Individual  attacks  of  the  dis- 
ease usually  do  not  cause  any  serious  disturbance  barring 
accidents  and  injuries. 

Treatment.— During  an  attack  of  vertigo  the  animal  should 
be  placed  in  a  comfortable,  quiet  place  and  protected  from 
injury.  Following  the  attack  the  examination  should  be 
directed  to  find  out  the  underlying  cause  and  treatment 
applied  accordingly.  When  the  condition  occurs  in  pigeons 
as  a  contagious  disease,  the  entire  premises  should  be  dis- 
infected after  the  removal  of  all  affected  birds.  Individual 
treatment  in  these  cases  is  unsatisfactory. 

EPILEPSY. 

Definition.— Epilepsy  is  a  disease  of  the  central  nervous 
system  which  is  characterized  by  convulsions  occurring  at 
irregular  intervals,  the  subject  usually  being  unconscious 
during  the  attack. 

Etiology.— The  cause  of  primary  true  epilepsy  is  unknown 
although  it  is  regarded  as  being  hereditary;  at  least  the 
offspring  of  epileptic  parents  are  markedly  predisposed  to 
the  disease.  This  has  been  observed  in  man  as  well  as  in  the 
domesticated  animals. 

Pathology.— No  postmortem  lesions  of  any  kind  have 
been  observed  either  in  animals  or  man  which  would  account 
for  the  disease. 

Symptoms.— In  epilepsy  the  attacks  come  on  suddenly, 
the.  animal  performing  uncontrollable  movements.  This  is 


EPILEPSY  459 

followed  by  the  subject  falling  to  the  ground  or  floor  and 
in  convulsions  of  a  clonic  type.  Generally  every  muscle  is 
involved,  including  the  facial  muscles.  There  is  champing 
of  the  jaws  with  salivation,  the  saliva  being  churned  into 
foam  and  often  blood-stained  due  to  injuries  of  the  tongue 
by  the  teeth.  The  visible  mucous  membranes  are  cyanotic; 
the  heart  beat  is  full  and  strong,  and  the  respirations  sus- 
pended. The  convulsions  last  but  a  few  seconds  and 
gradually  become  weaker  and  finally  cease.  The  animal 
lies  quietly  for  a  few  minutes,  then  rises  to  its  feet,  staggers 
and  finally  recovers.  The  attacks  do  not  occur  at  regular 
periods.  The  animal  may  have  two  or  more  in  a  day,  or 
there  may  be  weeks  or  months  between  attacks. 

Diagnosis.— It  is  difficult  to  differentiate  between  true 
epilepsy  and  secondary  or  reflex  epilepsy  which  is  merely  a 
symptom  of  some  other  disease.  A  history  of  chronicity 
and  the  rather  long  periods  between  the  attacks  point  to 
true  epilepsy.  Further,  true  epilepsy  may  be  seen  in  both 
old  and  young  animals  while  secondary  or  reflex  is  usually 
confined  to  the  young. 

Prognosis. — The  prognosis  is  unfavorable,  as  true  epilepsy 
is  considered  incurable. 

Treatment.— If  treatment  is  undertaken,  the  bowels 
should  be  kept  open  by  feeding  laxative  food  and,  if  neces- 
sary, the  administration  of  laxative  drugs  as  cascara  sagrada, 
fluidextract  (2.0-8.0),  or  sulphur  (2.0-6.0)  in  the  food  as 
required. 

The  periods  between  the  attacks  may  be  lengthened  by 
the  administration  of  bromides  in  full  doses,  the  bromid  of 
sodium  being  preferable  (0.5-4.0). 

Castration  is  said  to  have  a  beneficial  action  in  some  cases. 

Reflex  or  Secondary  Epilepsy.— This  is  seen  as  a  symptom 
of  several  diseases  occurring  in  small  animals  and  somewhat 
resembles  true  epilepsy. 

Reflex  or  secondary  epilepsy  is  sometimes  seen  in  rickets, 
inflammatory  diseases  of  the  digestive  tract,  some  infesta- 
tion with  internal  parasites,  during  the  eruption  of  the 
permanent  teeth,  in  constipation,  and  frequently  distemper, 
especially  the  nervous  form. 

It  is  seen  chiefly  in  young  animals,  being  quite  rare  in 


400  FUNCTIONAL  NERVOUS  DISEASES 

older,  while  true  epilepsy  affects  the  old  as  well  as  the 
young.  This  will  assist  in  the  differentiation  between  reflex 
and  true  epilepsy. 

Treatment.— Treatment  must  be  directed  toward  the 
primary  disease  or  condition  producing  the  symptoms. 

CATALEPSY. 

Definition. — This  is  a  peculiar  functional  disease  of  the 
central  nervous  system,  probably  of  the  cortex  of  the  brain. 
It  is  characterized  by  a  suspension  of  voluntary  motion  on 
the  part  of  the  subject,  but  when  the  position  of  the  animal 
is  passively  changed,  it  will  be  maintained  by  the  patient 
for  a  long  time. 

Etiology. —The  cause  of  catalepsy  is  not  known,  though 
it  is  probably  of  reflex  origin. 

Pathology.— No  pathological  lesions  of  the  central  nervous 
system  have  been  demonstrated.  Degenerative  changes  in 
the  muscles  have  been  observed,  also  small  hemorrhages 
in  the  stomach  and  intestines,  but  these  are  not  constant. 

Symptoms.— The  attacks  come  on  rather  suddenly,  the 
animal  becoming  rigid,  muscles  hard  and  tense.  The 
eyes  are  fixed  and  dull  in  appearance,  the  pupils  may  be 
dilated  or  contracted  to  the  utmost.  Sensation  seems  to 
be  inhibited  during  the  attack.  The  circulatory  and  respir- 
atory functions  are  undisturbed;  temperature  normal.  If 
the  position  of  the  animal's  limbs  be  passively  changed  it 
will  remain  in  that  position  for  a  long  time. 

Diagnosis. —This  is  made  chiefly  by  passively  changing 
the  position  of  the  body  of  the  animal  or  its  limbs.  If  it 
remains  in  this  position  without  change  for  a  considerable 
length  of  time,  the  attack  is  undoubtedly  catalepsy. 

Course.  —The  course  of  the  attacks  is  from  four  to  twenty- 
four  hours  from  which  the  animal  usually  recovers. 

Prognosis.— The  prognosis  is  not  unfavorable,  though  the 
attacks  may  recur. 

Treatment. —The  administration  of  antispasmodics  is  indi- 
cated. Give  morphin  (0.032-0.2)  subcutaneously,  or  chloral 
hydrate  (2.0-4.0)  in  emulsion  per  rectum.  This  will  relieve 
the  attack,  but  there  is  a  tendency  to  recurrence. 


ECLAMPSIA  461 

CHOREA. 

Definition.— This  is  a  persistent  clonic  spasm,  or  twitching 
of  certain  muscles,  or  group  of  muscles.  It  is  oftenest  seen 
in  the  dog;  rare  in  other  animals. 

Etiology.— Chorea  results  most  frequently  from  acute 
infectious  diseases  as  distemper  to  which  it  is  a  common 
sequel.  It  also  occurs  in  myelitis,  and  in  the  early  stages 
of  rachitis. 

Pathology.— There  is  no  demonstrable  lesion  observed 
even  in  the  most  careful  examination  which  might  account 
for  the  symptoms  shown.  Anemia  is  the  most  constant. 

Symptoms.— The  twitching  of  the  muscles  is  quite  constant 
and  usually  involves  those  of  the  head  and  anterior  limbs, 
though  often  one  or  both  of  the  pelvic  limbs  may  be  involved. 
There  is  a  peculiar  dipping  movement  of  the  head  and 
shoulders.  Often  the  masseter  muscles  are  the  only  ones 
involved  producing  a  spasmodic  movement  of  the  jaws. 
Consciousness  is  not  disturbed. 

These  rhythmic  spasms  are  less  marked  when  the  animal 
is  alone  and  during  sleep.  The  pulse  and  temperature  are 
normal;  the  appetite  unaffected.  The  disease  is  chronic  and 
may  persist  for  months  or  years.  Young  animals  frequently 
recover  without  treatment. 

Diagnosis.— Diagnosis  is  not  difficult.  The  history,  the 
peculiar  rhythmic  spasms  of  certain  muscles,  and  the  absence 
of  general  symptoms  point  clearly  to  chorea. 

Prognosis.— Prognosis  is  good  so  far  as  the  life  of  the  animal 
is  concerned,  but  bad  from  the  standpoint  of  recovery  or  cure. 

Treatment.— Many  kinds  of  treatment  have  been  tried 
but  none  have  given  decided  results.  Arsenic  in  the  form 
of  Fowler's  solution  (0.1-0.75)  once  daily  has  proved  helpful. 

Recently  leukocytic  extract  has  been  administered  experi- 
mentally with  excellent  results.  The  animal  should  be 
given  nourishing  food,  and  if  anemic,  iron  preparations  as 
iron  and  quinin  citrate  (0.2-0.7)  are  useful. 

ECLAMPSIA. 

Definition.— Eclampsia  is  a  tonoclonic  spasm  observed  in 
bitches.  It  is  associated,  though  in  some  cases  quite  remotely, 


462  FUNCTIONAL  NERVOUS  DISEASES 

with  parturition.     As  a  rule  the  animal  is  conscious  during 
the  attack. 

Etiology.— The  cause  of  eclampsia  is  not  definitely  known. 
It  occurs  in  pregnant  bitches  and  as  late  as  fifty  days  after 
whelping.  It  has  been  observed  to  follow  exposure  to  cold 
in  pregnant  bitches,  and  following  grief  or  anxiety  owing 
to  the  loss  of  one  or  more  of  the  puppies  in  suckling  bitches. 

Symptoms.— The  disease  appears  suddenly,  usually  about 
the  second  week  after  parturition,  though  it  may  occur 
before.  Generally  small  delicate  house  dogs  are  affected. 

Early  in  the  attack  the  animal  becomes  restless  and  has 
an  anxious  facial  expression.  Later  motor  disturbances 
are  seen,  the  animal  falls  to  the  ground  or  floor  in  spasms 
of  a  tonoclonic,  or  mixed  type,  the  legs  sticking  out  stiffly 
as  in  tetanus.  The  muscles  of  the  body  and  limbs  are  hard 
and  tense,  occasionally  the  limbs  will  relax  and  immediately 
become  stiff  again.  The  respiration  is  rapid,  and  the  pulse 
accelerated,  small  and  hard.  Visible  mucous  membranes 
are  congested.  There  is  some  salivation,  the  saliva  being 
swallowed  or  dripping  from  the  mouth.  The  eyes  are  open, 
pupil  normal,  and  the  corneal  reflex  present.  The  animal 
is  conscious  but  unable  to  obey  commands.  The  tempera- 
ture is  normal  or  subnormal. 

Diagnosis.— The  diagnosis  of  eclampsia  is  sometimes 
difficult.  It  might  be  confused  with  strychnin  poisoning, 
a  condition  it  closely  resembles,  but  in  eclampsia  there  is 
less  hyperesthesia.  It  might  also  be  confused  with  tetanus 
but  tetanus  comes  on  gradually,  this  being  about  the  only 
differential  feature. 

Prognosis.— If  the  animal  is  presented  for  treatment 
early,  the  prognosis  is  favorable.  Otherwise  it  is  unfavorable, 
especially  when  the  temperature  is  more  than  1|°  below 
normal. 

Treatment.— Give  narcotics  as  morphin  subcutaneously  in 
full  doses  and  keep  the  animal  in  a  warm,  quiet  place. 
Chloroform  syrup  (1  c.c.  of  chloroform  to  90  c.c.  of  simple 
syrup)  in  doses  of  4.0-8.0  every  fifteen  minutes  until  the  mus- 
cles relax,  then  at  longer  intervals  as  required,  may  be  given. 

Puppies  must  not  be  allowed  to  nurse  during  the  acute 
stage  and  should  be  kept  away  from  the  dam. 


PART  X. 
DISEASES  OF  THE  SKIN. 

CHAPTER  I. 
NON-PARASITIC  SKIN  DISEASES. 

Examination.— Careful  methods  are  required  for  an  accu- 
rate diagnosis  of  skin  diseases.  Small  diseased  areas  and 
the  larger  parasites,  if  not  very  numerous,  may  easily  be 
overlooked  in  long-haired  individuals,  or  in  birds. 

In  the  majority  of  cases  a  microscopic  examination  is 
necessary  to  determine  if  a  skin  disease  is  parasitic  or  non- 
parasitic.  If  the  former,  it  is  necessary  to  identify  the 
parasite  in  order  to  give  the  proper  prognosis  and  treatment. 

Some  few  cases  present  certain  rather  characteristic 
features  which  indicate  the  real  nature  of  the  disease  but 
the  only  accurate  diagnostic  method  is  by  the  use  of  the 
microscope.  The  larger  parasites  may  be  identified  with  a 
reading  glass;  the  mange  mites  can  be  seen  with  a  micro- 
scope, using  low  power,  while  high  power  is  necessary  to 
identify  some  of  the  vegetable  forms. 

Microscopic  Examinations. — With  a  small,  sharp  curette 
scrape  deeply  into  the  skin  at  a  point  where  the  disease 
process  is  active  until  a  mass  of  moist  scrapings  the  size 
of  a  grain  of  wheat  is  obtained.  Transfer  this  mass  directly 
to  a  slide  and  moisten  it  with  a  drop  of  water.  Put  on  a 
cover-glass  and  press  down  with  a  rotary  motion  to  evenly 
distribute  the  material  to  the  proper  density.  By  this 
method  animal  parasites  remain  active,  and  their  movements 
readily  indicate  their  presence.  For  vegetable  parasites 
30 


464  NON-PARASITIC  SKIN  DISEASES 

in  addition  to  the  scrapings  pluck  a  tuft  of  hair  at  the  edge 
of  the  diseased  area  and  mount  as  above.  Examine  with 
high  power  for  the  fungus  along  the  hair  near  the  roots.  If 
the  scrapings  are  to  be  examined  later,  secure  a  larger 
amount  and  put  in  a  clean  vial  or  ointment  box.  Smear 
slides  cannot  be  made  with  this  very  well  after  it  has  dried. 
Usually  it  is  best  to  boil  it  slightly  in  a  10  per  cent,  solution 
of  KOH.  Centrifuge  it  and  withdraw  some  material  from 
near  the  bottom  with  a  pipette  and  mount  with  cover-glass. 

DANDRUFF. 

Definition.— The  presence  of  fine,  grayish-white  scales  on 
the  skin  or  in  the  hair,  which  may  affect  the  entire  skin 
surface  or  small  circumscribed  areas. 

Etiology.— A  mild  superficial  inflammation  of  the  skin 
resulting  in  excessive  exfoliation  of  the  epidermis.  Dandruff 
may  be  due  to  several  causes,  viz.:  Bath  soaps  that  are 
too  irritating  or  used  too  often;  irritating  medicinal  prepa- 
rations used  on  the  skin,  especially  parasiticide  preparations; 
direct  sunshine  on  short-haired  animals,  especially  when 
unaccustomed  to  it  or  those  recently  sheared.  Parasites 
are  a  frequent  cause;  a  mild  attack  of  the  demodectic  para- 
sites will  occasionally  produce  no  other  symptoms.  Internal 
disorders,  especially  digestive  diseases  favor  the  condition. 
Very  often  no  assignable  cause  can  be  discovered. 

Symptoms.— The  disease  occurs  chiefly  on  the  upper 
surface  of  the  body,  especially  on  the  neck,  under  the  collar 
and  along  the  back.  The  hair  coat  is  dull  and  dry  and  the 
skin  is  covered  with  small  grayish-white  scales  or  dust. 
Itching  is  sometimes  present. 

Diagnosis.— The  presence  of  the  scales  indicates  the  condi- 
tion, and  only  the  absence  of  parasites  distinguishes  it  from 
parasitic  diseases. 

Prognosis. — The  disease  runs  a  rather  prolonged  course 
but  continued  treatment  usually  effects  a  cure. 

Treatment. — Good  nourishment  is  necessary  if  digestive 
disturbances  are  suspected  as  the  indirect  cause.  Internal 
treatment  with  digestive  tonics,  especially  preparations 


ALOPECIA  465 

containing  arsenic  for  its  action  on  the  skin.  The  external 
treatment  consists  in  cleaning  applications  with  alkaline 
solution  (sodium  carbonate,  2  per  cent.)  and  applications 
of  salicylic  ointment  (10  per  cent.).  A  solution  of  resorcin 
(5  per  cent.)  is  very  satisfactory  as  it  does  not  soil  the 
hair  coat,  nor  cause  dirt  to  adhere  to  it.  It  is  best  to  clip 
the  hair  and  brush  the  skin  well  before  medicinal  treatment 
is  begun,  and  thereafter  at  frequent  intervals. 

ALOPECIA. 

Definition.— A  loss  of  hair,  feathers  or  fur  from  large 
or  small  areas  due  to  causes  other  than  organic  diseases  or 
parasites. 

Etiology.— Mechanical.— Fowls,  especially  the  males  when 
penned,  may  pluck  the  feathers  from  the  breast,  denuding 
a  large  area.  Female  rabbits  pull  out  their  fur  for  use  in 
preparing  a  nest  for  their  young. 

Chemical. — Acids  or  strong  caustics  by  deep  action  on  the 
skin  will  destroy  the  hair  follicles  and  when  healing  occurs 
the  area  is  free  of  hair. 

Thermic.— Hot  water,  often  intentionally  applied,  may 
act  deeply  enough  to  destroy  the  follicles  and  denude  an 
area.  Burns  appear  similar  but  more  diffuse. 

The  most  common  cause  is  deranged  nutrition  to  such 
an  extent  that  the  hair  falls  out  usually  in  patches  over  the 
body.  A  single  area,  so  affected,  and  when  the  usual 
etiological  factors  are  wanting,  must  be  ascribed  to  a  dis- 
turbance of  the  trophic  skin  nerves  of  that  part.  In  one 
case  the  hair  was  lost  each  succeeding  summer  from  pig- 
mented  parts  of  the  skin.  No  cause  could  be  given. 

Pathology. --The  hair  appears  to  loosen  in  patches  and  fall 
out.  The  skin  appears  almost  normal  in  some  cases  but 
usually  somewhat  dry  and  hard.  In  those  cases  following 
severe  wounds,  scalds,  or  burns,  the  skin  shows  scar  forma- 
tion. The  microscopic  examination  for  parasites  is  negative. 

Symptoms.— There  appear  on  the  skin  small  areas  de- 
nuded of  hair,  which  gradually  become  larger.  The  hair 


466  NON-PARASITIC  SKIN  DISEASES 

at  other  parts  can  be  readily  pulled  out.  The  skin  of  fowls, 
when  feathers  have  been  plucked,  appears  apparently 
healthy,  as  does  that  of  rabbits  which  have  pulled  out  the 
fur.  When  due  to  wounds,  scalds  and  burns  the  skin  is 
thickened,  often  scaly  and  the  hair  around  the  affected 
area  often  distorted  from  its  usual  direction  of  growth, 
appearing  longer  at  the  margins. 

Diagnosis.— This  is  made  by  negative  microscopic  exami- 
nation of  skin  scrapings,  and  inspection  of  skin  for  scars. 
Observing  or  inquiring  into  the  habits  of  the  animal  affected,  and 
a  careful  examination  into  its  general  condition  are  helpful. 

Differential  Diagnosis.— Alopecia  must  not  be  confused 
with  demodectic  mange,  which  frequently  causes  loss  of 
hair  in  small  but  gradually  enlarging  areas,  nor  with  the 
depluming  mite  which  acts  similarly  on  fowls. 

Prognosis.— Good  if  due  to  general  nutrition  disturbance. 
If  from  scar  formation  the  loss  is  permanent,  as  is  also  true 
of  trophic  nerve  disturbance. 

Treatment.— Treatment  consists  in  giving  good  food  in 
proper  amounts,  and  stimulating  metabolism  by  tonics, 
especially  those  containing  arsenic  for  its  alterative  action 
on  the  skin.  Scarified  areas,  if  small,  may  be  overcome  by 
complete  removal  of  the  areas  and  the  healthy  skin  approxi- 
mated by  suturing.  Feather  pulling  may  be  prevented  by 
allowing  free  range,  or  by  using  a  device  attached  around 
the  upper  half  of  the  beak  which  prevents  complete  closing 
but  does  not  inconvenience  the  bird  in  eating  or  drinking. 
Fur  pulling  of  rabbits  is  not  objectionable  when  their  habits 
are  known.  It  may  be  overcome  in  part  by  supplying 
proper  material  for  bedding  just  before  parturition. 


DERMATITIS. 

Definition.— An  acute  or  subacute,  septic  or  aseptic 
inflammation  of  the  skin.  It  may  be  local  or  general. 

Etiology.— Parasites. — Probably  more  inflammatory  con- 
ditions of  the  skin  in  small  animals  are  due  to  small  parasites 


DERMATITIS  467 

than  to  all  other  causes  combined,  therefore,  such  are  consid- 
ered under  parasitic  skin  diseases. 

Mechanical, — Traumatic  causes  may  be  pressure,  as  lying 
on  hard  floor,  whipping,  bites  (flies),  running  through  brush  as 
hunting  dogs  do,  excessive  wagging  of  the  tail,  friction  when 
bathing  by  use  of  stiff  brush,  and  shaking  the  ears. 

Chemical. — Chemical  agents  as  strong  caustic  soaps  or  the 
too  frequent  use  of  ordinary  soap;  irritating  medicinal  prepar- 
ations, as  parasiticides  improperly  applied,  or  vesicatory 
agents  as  mustard.  Acids  intentionally  applied,  caustics 
as  use  of  lime  in  dusting  pens  for  poultry,  and  bee  or  wasp 
stings  are  also  causes. 

Thermic. — Thermic  causes  are :  Scalding,  burning,  freezing 
or  exposure  to  direct  sun  rays  of  animals  unaccustomed  to 
it  after  having  been  sheared. 

Infectious. — Infections  of  Bacillus  necrophorus,  especially 
in  suckling  young,  produce  serious  necrotic  sloughs  of  the 
skin.  Secondary  dermatitis  is  frequently  seen  during  the 
course  of  distemper  in  dogs. 

Pathology.— The  mild,  acute  form  reddens  the  skin,  which 
becomes  sensitive,  but  is  otherwise  little  changed.  The 
subacute  form  is  shown  by  a  thickening  and  hardening  of 
the  skin.  The  skin  feels  rough  and  fissured.  Any  serous 
or  hemorrhagic  discharge  soils  the  hair  and  forms  crusts. 
The  microscopic  examination  for  parasites  is  negative  and  the 
skin  itself  shows  an  increase  of  connective  tissue  and  general 
infiltration  often  to  the  extent  of  separation  of  the  layers. 

Symptoms.  — Pruritus  is  usually  the  first  noticeable  symp- 
tom which  causes  repeated  scratching,  rubbing  on  the 
ground  or  floor  and  licking  the  part.  In  hunting  dogs, 
especially  at  the  beginning  of  the  season,  the  skin  over  the 
chest  and  anterior  part  of  limbs,  between  the  toes,  and 
on  the  end  of  the  tail,  will  be  reddened  and  moist,  often 
bleeding,  while  the  dog  is  being  used  in  the  field.  In  dogs 
and  cats  following  the  use  of  strong  or  the  too  frequent  use 
of  bath  soaps,  and  in  poultry  from  dusting  them  in  lime,  a 
mild,  acute,  diffuse  dermatitis  ensues.  Its  persistence 
depends  on  the  continuance  of  the  causes.  Sleeping  on 
hard  surfaces  without  bedding  causes  a  chronic  local  der- 


468  NON-PARASITIC  SKIN  DISEASES 

matitis,  especially  in  large  dogs,  which  appears  in  the  form 
of  a  thickened,  roughened,  hairless  area  over  the  elbow 
(scleroderma) .  A  persistent  form  of  dermatitis  occurs  as 
a  result  of  injuries  to  the  edge  of  pendulous  ears  and  the 
irritation  induces  frequent  shaking  of  the  head  which 
serves  to  aggravate  the  condition.  Fly  bites  on  the  ears  to 
the  extent  of  producing  severe  inflammation  are  common. 

Diagnosis.— Negative  microscopic  examination  with  con- 
sideration of  the  several  causes  assists  in  making  a  diagnosis. 

Prognosis.— Good,  especially  in  acute  conditions  when  the 
causes  can  be  removed. 

Treatment.— Mild  acute  forms  may  be  treated  success- 
fully with  the  application  of  lead  water  or  drying  powders. 
When  crusts  have  formed,  soiling  the  hair,  a  cleansing  wash 
of  a  sodium  carbonate  solution  (5  per  cent.)  repeated  daily 
is  very  good  and  will  relieve  the  itching  usually  present  in 
this  form.  Chronic  forms  necessarily  require  longer  treat- 
ment with  preparations  to  soften  the  skin  as  lanolin  or 
ichthyol  ointment.  The  chronic  form  which  occurs  on  the 
edge  of  pendulous  ears  can  be  successfully  treated  only  by 
bandaging  which  prevents  the  animal  shaking  the  ears. 
The  bandage  should  be  so  applied  that  the  affected  tips  are 
exposed  for  treatment  with  creolin  ointment.  This  aids 
healing  and  prevents  further  injury  from  fly  bites,  the  most 
usual  source  of  this  trouble.  If  the  ears  are  very  much 
thickened  it  may  be  advisable  to  remove  the  edges  evenly 
and  immobilize  until  complete  healing  occurs.  Gangrenous 
dermatitis  requires  prompt  treatment  by  removing  the 
affected  parts  of  skin  and  applying  strong  antiseptics. 

ACNE. 

Definition.— An  inflammation  of  the  glands  of  the  skin 
with  enlargement,  appearing  as  small  nodules  in  the  skin. 
Quite  frequently  they  pass  on  into  pustules. 

Etiology.— Irritation  of  the  glands  by  rubbing,  or  by  the 
collar,  or  when  there  is  an  obstruction  to  the  glandular 
openings  by  accumulations  of  dirt  or  medicinal  substances 
which  have  been  applied.  Preparations,  as  creolin,  con- 


ECZEMA  469 

tinued  for  a  time  may  produce  inflammation  of  the  glands. 
The  bacteria  always  present  in  the  skin  find  favorable  con- 
ditions in  an  obstructed  gland  and  soon  convert  it  into  a 
pustule.  Acne  is  secondary  to  an  invasion  of  the  hair 
follicles  and  glands  with  parasites.  (See  Demodex  Mange.) 

Pathology.— Small  elevations  appear  on  the  skin.  They 
may  be  scattered  or  appear  in  groups.  As  the  condition 
advances  a  few  show  a  change  to  pustular  form. 

Symptoms.— Small,  round  elevations  varying  in  size  up 
to  that  of  a  pea  appear  on  above-mentioned  parts  of  the 
skin.  Inflammatory  symptoms  are  present  and  the  skin 
is  quite  sensitive.  Small,  clear  vesicles  appear  and  soon 
become  turbid,  rupture  and  their  contents  dry  to  form  a 
scab.  These  scabs  fall  off  and  leave  a  small  area  denuded 
of  hair  for  some  time.  Some  nodules  may  gradually  dis- 
appear in  one  to  two  weeks  without  disturbance  of  the  skin 
or  hair  over  them.  All  stages  of  the  disease  may  be  present 
at  the  same  time. 

Prognosis. —The  prognosis  is  good.  Recovery  occurs  in 
one  to  two  weeks,  either  by  pustular  formation,  rupture 
and  escape  of  the  contents,  or  by  gradual  reduction  of  the 
inflammatory  process. 

Treatment. —Thoroughly  cleanse  the  affected  parts  of  the 
skin  with  a  warm  alkaline  solution;  in  the  nodular  stage 
salicylic  ointment  (5  per  cent.)  may  be  used.  As  the 
nodules  become  softened  the  contents  should  be  squeezed, 
after  opening  if  necessary,  and  washed  out  with  antiseptic 
solutions.  Internally  the  administration  of  Fowler's  solu- 
tion is  usually  beneficial.  The  use  of  tar,  phenol,  sulphur 
or  salicylic  acid  preparations  is  contra  indicated  in  cases  of 
acne  due  to  chemical  irritations  of  the  skin  as  they  usually 
aggravate  the  condition. 

ECZEMA. 

Definition.— A  chronic  inflammation  of  the  skin  in  the 
course  of  which  papules,  vesicles  and  pustules  develop. 
Rupture  of  these  complicate  the  condition  by  causing  the 
skin  to  be  moist  and  covered  with  crusts  matted  in  the 


470  NON-PARASITIC  SKIN  DISEASES 

hair.  Under  these  crusts  infection  flourishes  and  decora- 
position  occurs,  further  irritating  the  skin. 

Etiology. —Various  irritants  which  produce  dermatitis 
may  be  the  remote  causes  of  eczema.  The  most  frequent 
external  cause  is  the  accumulation  of  dirt  on  the  skin, 
especially  when  the  hair  is  long.  Consequently  the  regions 
most  commonly  affected  are  the  root  of  the  tail,  along  the 
back,  shoulders,  neck  and  back  of  the  ears.  It  is  more 
common  in  long-haired  dogs.  Digestive  disturbance  has 
an  indirect  relation  to  eczema.  Decomposing  food  is  a 
common  cause,  as  is  overfeeding.  Probably  the  most 
persisting  forms  of  eczema  occur  in  overfed,  fat  animals. 

Pathology . —The  skin  may  show  all  the  stages  of  inflam- 
mation from  acute  to  chronic.  As  it  is  a  chronic  condition, 
the  acute  symptoms  are  usually  induced  by  scratching  or 
biting  the  parts. 

Symptoms.— The  early  stages  appear  as  an  ordinary 
dermatitis  progressing  through  the  various  stages  of  inflam- 
mation until  the  pustular  eruptions  occur.  Recovery  may 
occur  spontaneously  at  this  time,  or  with  proper  treatment, 
but  if  not  it  passes  on  to  the  eczematous  stage.  Pustules 
continue  to  form  and  discharge  their  contents  often  unno- 
ticed, under  the  long  hair  and  crusts.  If  sufficient  to  keep 
the  skin  moist  it  is  commonly  classed  as  weeping  eczema. 
The  itching  is  intense,  and  the  frequent  scratching,  biting 
or  rubbing  removes  the  matted  hair  and  crusts  leaving  a 
raw  bleeding  surface.  The  skin  lesions  may  occur  in  one  or 
more  small  areas  or  over  a  gradually  increasing  large  surface. 
In  consequence  of  continued  efforts  to  relieve  the  itching  by 
licking  and  scratching,  the  inflammation  extends  into  the 
deeper  layers  of  the  skin.  Healing  occurs  in  three  or  four 
weeks  with  recurrence  of  the  condition.  The  skin  becomes 
thickened  and  fissured,  and  bleeds  easily.  Scales  continue 
to  form  on  these  partly  healed  areas.  Some  of  the  hair  bulbs 
atrophy  or  are  destroyed  and  only  a  partial  growth  of  hair 
reappears  on  the  surface.  A  recurrence  of  the  condition  each 
succeeding  summer  is  quite  common  in  well  fed  house  pets 
especially  among  well  bred  dogs  with  fine  skins,  as  the 
poodle. 


ECZEMA  471 

Diagnosis.— A  diagnosis  can  only  be  made  by  the  exclusion 
of  parasitic  conditions  and  the  more  acute  forms  of  dermatitis 
and  acne. 

Prognosis.— Favorable  in  the  earlier  stages,  but  when  the 
skin  becomes  thickened,  hard  and  fissured,  healing  is  as  a 
rule  only  temporary,  as  acute  relapses  occur.  When  occurring 
as  result  of  a  chronic  internal  disease  the  prognosis  is  espe- 
cially unfavorable. 

Treatment.— Carefully  cleanse  the  affected  parts,  remove 
all  the  crusts  and  scabs  possible,  and  clip  any  hair  that  may 
be  over  the  part  and  for  some  distance  around  the  margin. 
Mild  soap  may  be  used  for  washing,  also  alkaline  solution 
(sodium  carbonate  5  per  cent.).  Upon  the  condition  of  the 
skin  further  treatment  depends.  If  the  surface  is  moist, 
drying  powders  can  be  used,  such  as  talcum,  zinc  oxid,  or 
boric  acid.  Liquid  preparations  of  lead  and  zinc  (Burrow's 
solution)  are  also  very  good.  Proper  internal  treatment  is 
important  in  all  cases  of  eczema  as  has  been  shown  by  marked 
improvement  from  this  form  of  treatment  alone.  Mild  pur- 
gatives, especially  calomel  (0.06-0.12)  or  magnesium  sulphate 
(8.0-12.0),  for  their  antiseptic  and  laxative  action  repeated 
at  two-  or  three-day  intervals.  Fowler's  solution  (0.19-0.58) 
daily  for  dogs  gives  the  best  general  results  and  should  be 
continued  for  a  long  time.  Calcium  chlorate  (15.0-30.0) 
in  solution  daily  acts  to  relieve  the  itching.  A  good  diet 
of  easily  digested,  non-irritating  foods  is  essential. 


CHAPTER  II. 
PARASITIC  SKIN  DISEASES. 

FLEAS. 

Description.— Fleas  are  large  enough  to  be  seen  with  the 
naked  eye,  but  magnification  is  necessary  to  distinguish  the 
species.  They  are  a  jumping  insect  without  wings,  brown  in 
color  and  about  2  to  4  mm.  long.  The  female  is  the  larger. 
They  obtain  nourishment  by  sucking  blood.  They  readily 
pass  from  one  animal  to  another  and  may  reside  in  dust, 
filth,  etc.  The  eggs  are  dropped  or  deposited  on  the  ground 
or  floor  and  hatch  in  six  to  twelve  days.  The  final  transforma- 
tion into  perfect  insects  requires  three  to  five  weeks  depending 
upon  the  temperature. 

Occurrence.— The  dog  is  the  most  commonly  affected  of 
the  small  animals,  with  the  Ctenocephalus  canis,  the 
common  dog  flea.  The  Pulex  irritans  of  man  will  also  live 
on  dogs.  The  cat  (Ctenocephalus  felis)  is  rarely  affected 
except  when  closely  associated  with  infested  dogs.  They 
suffer  considerable  annoyance  but  the  fleas  soon  leave  of 
their  own  accord.  Hares  and  rabbits  harbor  the  rabbit  flea 
(Pulex  gonivcephalus),  but  may  also  be  the  hosts  of  the  dog 
and  human  flea.  On  fowls,  pigeons  and  other  birds  the  bird 
flea  (Pulex  avium)  is  parasitic. 

Symptoms.— Fleas  are  most  common  on  dogs  and  pigeons. 
Sedentery,  feeble  or  young  animals,  or  those  nursing  young, 
or  birds  incubating  eggs,  are  particularly  susceptible;  also 
animals  kept  in  close  quarters.  Fleas  are  tormenting  and 
harm  the  animal  chiefly  by  disturbing  rest  and  quiet.  Large 
numbers  may  produce  chronic  skin  eruptions,  but  the  most 
damage  to  the  skin  results  from  frequent  and  persistent 
scratching  which  produces  irritated  areas  on  the  skin  of  the 
neck,  back  of  the  ears,  and  back  of  the  forearm.  The  skin 


LICE  473 

is  soiled  with  the  excrement  of  the  parasite  which  appears 
as  brown  specks  scattered  through  the  hair.  Birds  pick  and 
scratch  the  skin  to  relieve  the  irritation  and  pluck  at  their 
feathers.  Severe  infestations  in  young  or  feeble  animals 
may  finally  cause  death  from  exhaustion. 

Diagnosis.— The  diagnosis  is  easy  by  identifying  the  flea. 
It  is  well  to  be  careful  not  to  attribute  a  severe  condition  to 
fleas  alone  as  smaller  parasites  may  also  be  present. 

Treatment.— The  destruction  of  fleas  on  dogs  and  cats  is 
best  effected  by  the  use  of  creolin  (1  to  2  per  cent.)  solution. 
It  is  cheap,  only  slightly  toxic  and  may  be  applied  to  the 
entire  skin  surface  at  one  time,  and  will  destroy  all  fleas  with 
which  it  comes  in  contact.  The  odor  which  persists  for  two 
or  three  days  will  prevent  further  infestation  only  for  that 
period,  consequently  a  thorough  cleansing  of  the  premises 
and  the  repeated  use  of  the  creolin  solution  in  the  kennel 
are  necessary  for  permanent  relief.  Creolin  is  somewl  at 
irritating  to  the  animal's  eyes  which  may  be  avoided  by 
careful  bathing.  Owing  to  the  odor  it  is  not  advisable  to 
use  it  on  house  pets.  Instead  pyrethrum  or  insecticide  pow- 
ders containing  same  should  be  used  by  dusting  it  well  in  the 
hair  or  feathers  and  then  brushing  it  out  in  fifteen  to  thirty 
minutes.  Serious  results  have  followed  the  too  liberal  and 
careless  use  of  it.  Frequent  cleansing  of  both  animals  and 
quarters  is  discouraging  to  these  pests.  The  use  of  powdered 
tobacco  in  the  bedding  or  sprinkling  the  floor  with  creolin 
solution  usually  serves  to  prevent  further  infestation.  Dogs 
permitted  free  range  will  soon  become  reinfested  from  asso- 
ciation with  others.  The  nests  of  birds  may  be  kept  free 
from  lice  by  mixing  powdered  tobacco  with  the  straw.  Gum 
camphor  may  be  used  in  the  same  way. 

LICE. 

Description.— The  louse  as  ordinarily  classed  covers  all 
the  wingless  parasites  which  do  not  jump.  Lice  do  not  leave 
their  hosts  except  the  fowl  louse  which  drops  off  after  engorge- 
ment with  blood  to  return  again  when  the  birds  return  to 
roost.  They  are  dull  white  in  color  except  when  engorged 


474  PARASITIC  SKIN  DISEASES 

with  blood.  The  eggs,  commonly  called  nits,  are  firmly 
glued  to  the  hairs  or  feathers.  The  young  are  similar  in 
shape  to  the  adults  but  only  attain  full  size  after  several 
changes.  The  females  are  larger  and  more  numerous  than 
males.  Phthiriasis  or  lousiness  is  a  term  applied  to  the  con- 
dition of  an  animal  or  bird  infested  with  lice.  Two  kinds  of 
lice  affect  small  animals:  The  Linognathus  piliferus  which 
obtains  nourishment  by  sucking  blood,  and  the  Trichodectes 
latus  which  lives  by  eating  the  epidermal  scales  and  hair. 
The  former  may  be  recognized  by  its  elongated  head;  the 
head  of  the  latter  is  short  and  broad.  The  common  louse  of 
the  dog  is  the  Linognathus  piliferus  (Hematopinus  piliferus), 
whic,h  may  also  live  on  ferrets,  and  the  Trichodectes  latus. 
The  cat  louse  is  Trichodectes  subrostratus,  and  a  rare  species 
of  Linognathus  piliferus  is  sometimes  found  on  rabbits. 
Several  species  of  blood  sucking  lice  infest  fowls  and  birds, 
chiefly  the  Menopum  trigonocephalum,  while  a  larger  one, 
the  Menopum  biseriatum,  is  most  commonly  found  on  the 
heads  of  young  chicks.  By  cohabitation  of  the  different 
species  of  fowls  parasites  peculiar  to  one  of  the  species  may 
be  found  on  others.  Other  animals  or  man  coming  in  contact 
with  articles  where  lousy  fowls  roost  will  become  infested, 
but  the  lice  soon  leave  their  illegitimate  host  and  the  irritated 
condition  soon  ends  unless  conditions  favor  further  infesta- 
tion as  when  straw  is  used  from  barns  where  fowls  roost. 

Symptoms.— The  blood-sucking  louse  causes  the  most 
annoyance.  Consequently  dogs  and  fowls  are  the  greatest 
sufferers.  The  dog  is  not  so  frequently  infested  nor  does 
he  suffer  as  much  as  fowls  in  which  phthiriasis  is  a  serious 
condition,  causing,  the  birds  to  lose  their  rest  and  become 
emaciated.  It  also  interferes  with  the  rearing  of  young. 
While  incubating,  when  conditions  are  ideal  for  a  rapid 
increase  in  these  parasites,  fowls  suffer  to  such  an  extent  as 
to  be  compelled  to  leave  the  nest,  or  remaining,  often  die 
from  exhaustion  from  loss  of  blood  and  irritation.  Newly 
hatched  chicks  are  frequent  sufferers  from  large  numbers  of 
lice  especially  the  large  ones  on  the  head.  The  dog  does  not 
seem  to  resent  the  presence  of  lice  as  much  as  fleas,  hence 
scratching  and  rubbing  is  less  pronounced.  A  mild  derma- 


SCABIES— MANGE— RED  MANGE— ITCH  475 

titis  may  result  from  both  parasitic  wounds  and  scratching 
especially  along  under  the  surface  of  the  neck.  Fowls  and 
birds  scratch  and  pick  themselves  and  pluck  feathers,  and, 
as  the  parasites  increase  gradually,  exhibit  all  the  symptoms 
of  cachexia.  With  increasing  numbers  of  lice  emaciation 
increases,  the  birds  appear  droopy  and  a  few  may  finally 
die  from  exhaustion.  Canaries  and  parrots  are  frequent 
sufferers  with  the  same  symptoms. 

Diagnosis. — The  diagnosis  of  lice  is  easy  when  the  size  of 
the  species  is  known.  Numbers  sufficient  to  cause  noticeable 
symptoms  are  readily  seen.  Mange  in  dogs  has  been  occa- 
sionally overlooked  because  the  pruritus  was  ascribed  to 
lice. 

Prognosis.— Phthiriasis  is  serious  and  obstinate  when  young 
or  feeble  animals  are  affected,  or  when  the  number  of  animals 
is  large  and  they  have  extensive  range.  Ordinarily  it  is  not 
serious  if  treated,  as  many  remedies  are  efficacious.  Exten- 
sive obstinate  cases  reported  have  often  proved  to  have  a 
coincident  infestation  with  mange  mites. 

Treatment. — Cleanliness  discourages  lice.  In  short-haired 
animals  it  is  most  easily  attained.  Long-haired  animals  should 
be  closely  clipped  and  thoroughly  brushed.  The  use  of  a 
creolin  solution  (2  per  cent.)  is  very  effective.  It  may  be 
used  as  a  bath  and  applied  to  kennel  and  runways.  For 
poultry  frequent  applications  of  creolin  (2  per  cent.)  or  other 
parasiticides  to  the  roosts  and  nesting  places  are  sufficient 
for  most  of  the  birds.  A  small  amount  of  oil  of  anise  applied 
under  the  wing  has  proved  of  value  in  the  treatment  of 
canary  birds.  Sulphur  and  lard  (5.0-20.0)  has  also  been  used. 
Those  showing  severe  symptoms  should  have  special  treat- 
ment. Tobacco  or  gum  camphor  placed  in  the  nests  is  usually 
necessary  to  protect  incubating  fowls  and  little  chicks. 

SCABIES.     MANGE.     RED  MANGE.     ITCH. 

Definition.— Mange  is  a  contagious  disease  of  the  skin  due 
to  so-called  mites. 

Etiology.— Two  kinds  of  mites,  the  Sarcoptes  and  the 
Demodex,  are  the  chief  ones  found  on  small  animals.  They 


476  PARASITIC  SKIN  DISEASES 

are  quite  small  and  can  only  be  recognized  when  highly 
magnified. 

Sarcoptes  Mite.— This  is  the  most  common  mange  mite 
and  is  distinguished  by  its  tortoise-like  appearance,  an 
elongated  horseshoe-shaped  head,  and  four  pairs  of  short, 
thick  legs.  In  the  male,  which  is  the  smaller,  the  first  and 
fourth  pairs  of  legs  are  provided  with  a  distinct  cup-shaped 
disk,  but  only  the  first  and  second  pairs  are  so  provided  in 
the  female.  The  other  legs  are  each  supplied  with  a  long 
bristle.  These  parasites  make  burrows  in  the  skin  where  they 
live  and  obtain  nourishment  and  in  which  the  female  deposits 
eggs.  The  eggs  hatch  in  five  to  eight  days  and  the  parasite 
is  fully  developed  in  two  to  three  weeks.  They  increase 
rapidly.  It  is  estimated  that  a  million  and  a  half  are  pro- 
duced in  three  months,  under  favorable  conditions,  from  a 
single  female.  The  sarcoptes  mite  varies  slightly  in  size  and 
minor  details  according  to  the  species  of  animal  upon  which 
it  lives.  This  makes  several  varieties  which  are  sometimes 
described  as  so  many  species.  Most  of  the  sarcoptes  mites 
live  exclusively  on  their  particular  host,  but,  due  to  intimate 
association,  may  be  found  occasionally  on  others. 

Pathology.— The  skin  shows  symptoms  of  chronic  inflam- 
mation varied  according  to  the  severity  of  the  attack.  In 
mild  cases  dry  crusts  and  scales  cover  the  surface  while  the 
severe  ones  show  a  much  wrinkled  and  sometimes  moist 
surface.  Fresh,  bleeding  areas  may  be  associated  with  the 
condition  as  the  result  of  scratching  or  rubbing  the  part. 

Sarcoptes  Mite  of  the  Dog  (Sarcoptes  scabiei,  variety  canis). 
-This  is  the  common  mite  found  on  the  dog.  Sarcoptic 
scabies  may  appear  on  any  part  of  the  body  but  usually 
around  the  head.  If  unchecked  it  gradually  spreads,  becom- 
ing generalized  in  four  to  eight  weeks.  Scratching  and  rub- 
bing induced  by  the  intense  pruritus  are  the  first  noticeable 
symptoms.  Small  red  spots  appear  followed  by  papules  and 
pustules  and  these,  ruptured  by  scratching,  lead  to  formation 
of  moist  areas  which  continue  to  spread.  The  areas  first 
invaded  soon  become  dry.  Yellowish-gray  crusts  form  and 
gradually  scale  off.  The  hair  falls  out  during  the  process. 
The  skin  becomes  thickened  and  shows  wrinkles  and  thick 


SCABIES— MANGE— RED  MANGE— ITCH  477 

folds.  The  dog  gives  off  an  offensive  but  characteristic  odor, 
and  is  repulsive  in  appearance.  Emaciation  increases,  and, 
if  not  treated,  death  occurs  from  cachexia  and  exhaustion. 
In  some  cases  the  skin  remains  dry  with  profuse  desquama- 
tion  of  bran-like  scales;  it  may  be  and  often  is  mistaken  for 
a  non-parasitic  condition. 

Sarcoptes  Mite  of  the  Cat  (Notcedres  cati,  var.  cati;  Sarcoptes 
minor,  var.  cati).— Scabies  of  the  cat  usually  affects  the  head 
and  neck,  only  occasionally  invading  the  legs.  The  acute  stages 
are  less  marked  than  in  the  dog,  probably  due  in  part  to  less 
violent  scratching.  The  process  continues  with  slight  pustular 
eruption  and  the  formation  of  crusts.  Sometimes,  especially 
when  irregularly  treated,  it  continues  for  months  as  a  very 
mild  condition  with  only  slight  thickening  of  the  skin  and 
scanty  crust  formation.  The  crusts  are  most  noticeable  on 
the  edges  of  the  ears  and  there  is  often  a  slight  loss  of  hair 
on  top  of  the  head.  In  more  severe  cases  the  skin  becomes 
thickened,  hard  and  wrinkled.  The  eyelids  become  involved 
resulting  in  an  intense  conjunctivitis.  The  thickening  of  the 
skin  around  the  nostril  openings  may  be  sufficient  to  interfere 
with  respiration.  The  animal  gradually  becomes  emaciated, 
exhausted  and  death  occurs  usually  in  four  to  six  months. 
Young  animals  die  earlier. 

Sarcoptes  Mite  of  the  Rabbit  (Xotoedres  cati,  vir.  cuniculi; 
Sarcoptes  minor,  var.  cuniculi). —  In  rabbits  scabies  attacks 
chiefly  the  skin  of  the  head,  particularly  around  the  eyes, 
nose  and  at  the  base  of  the  ears.  It  frequently  extends  to  the 
hind  and  sometimes  to  the  forepaws.  The  lesion  resembles 
that  seen  in  cats.  Itching  is  intense  inducing  continual 
scratching  and  rubbing;  the  fur  falls  out  and  thick,  gray 
scabs  appear.  As  the  process  continues  the  eyes  become 
surrounded  by  masses  of  dry  exudate.  Conjunctivitis  is  also 
present.  By  affecting  the  lips  prehension  of  food  is  difficult. 
Emaciation  appears  early,  and,  if  untreated,  the  animals 
invariably  die  in  three  to  five  months.  The  disease  is  highly 
communicable  and  serious  in  young  animals. 

Sarcoptes  Mite  of  the  Ferret  (Sarcoptes  scabiei,  var.  hydro- 
chaeri).— This  disease  in  ferrets  is  usually  confined  to  the 
head  and  feet.  The  affected  skin  is  usually  found  covered 


478  PARASITIC  SKIN  DISEASES 

with  dirty  yellow  crusts.  Crusts  also  form  on  the  plantar 
surface  of  the  feet  and  at  the  root  of  the  claws  which  become 
swollen  and  distorted.  To  relieve  the  intense  itching  the 
animal  frequently  scratches  and  bites  itself,  at  times  gnawing 
the  feet  so  viciously  that  they  become  severely  wounded. 
Walking  is  difficult,  the  weight  being  thrown  on  posterior 
parts  of  the  foot.  A  disagreeable  odor  is  exhaled  from  the 
animal. 

Sarcoptes  Mite  of  the  Fowl  (Cnemidocoptes  mutans,  Sarcoptes 
mutans,  var.  gallince) . — These  parasites  burrow  under  the  scales 
on  the  featherless  parts  of  the  skin  of  the  feet  and  legs.  The 
resulting  exudate  elevates  the  scales  and  there  is  a  formation  of 
a  white  granular  matter  agglutinated  by  the  exuded  serum. 
Irregular  masses  of  crusts  separated  by  fissures  continue  to 
form  and  usually  involving  all  of  the  skin  on  both  legs.  They 
are  firmly  adherent  and  when  detached  leave  the  skin  raw 
and  bleeding.  The  crusts  become  of  a  soft,  spongy  consist- 
ency due  to  the  numerous  furrows  excavated  by  the  parasite. 
Movements  of  the  joints  aggravate  the  condition;  walking 
and  even  standing  are  difficult  and  painful.  Occasionally 
an  entire  toe  may  drop  off.  The  course  of  the  disease  is 
slow,  the  fowls  become  emaciated  and  finally  die  from 
exhaustion. 

Diagnosis.— An  accurate  diagnosis  is  possible  only  by  a 
careful  microscopic  examination.  Otherwise  sarcoptic  mange 
may  be  mistaken  for  many  other  diseases  of  the  skin.  It  is 
essential  to  detect  and  identify  the  parasite  before  a  correct 
diagnosis  can  be  made. 

Prognosis.— Mild  cases  with  local  lesions  only  may  be 
treated  with  very  good  results.  This  is  especially  true  in 
cats.  Severe  cases,  where  the  process  affects  the  entire  skin 
surface,  are  almost  incurable  especially  if  symptoms  of 
emaciation  and  exhaustion  are  present. 

Treatment.— It  is  necessary  to  remove  all  the  hair  coat,  if 
long.  A  possible  exception  may  be  made  when  the  disease 
is  strictly  localized  as  in  cats.  Cleanse  the  skin  and  remove 
all  scales  and  crusts  by  using  an  alkaline  wash  (sodium 
carbonate  2  per  cent.,  or  soapy  water)  applied  with  a  fairly 
stiff  brush.  However,  indiscriminate  brushing  should  be 


SCABIES— MANGE— RED  MANGE-ITCH  479 

avoided  in  localized  cases  as  it  may  tend  to  spread  the  dis- 
ease to  healthy  parts  of  the  skin.  Care  must  be  observed  in 
washing  the  cat,  rabbit  and  ferret  as  they  do  not  endure 
bathing  very  well.  In  some  cases  softening  of  the  crusts  is 
advisable  which  may  be  accomplished  by  using  carbolated 
oil  or' glycerin.  For  dogs,  even  in  the  early  stages  with  only 
small  areas  affected,  vigorous  treatment  is  advisable  and 
careful  repeated  inspection  is  necessary  to  detect  new  areas. 
This  is  especially  true  in  long-haired  individuals.  Most  any 
of  the  parasiticides  are  more  or  less  effective  and  failures  are 
due  as  much  to  improper  application  as  to  the  preparation 
used.  Alcohol  or  aqueous  preparations  are  convenient  to 
apply  but  they  are  less  energetic  than  those  prepared  with 
an  oleaginous  base.  These  will  adhere  to  the  skin  longer 
and  at  the  same  time  penetrate  to  the  deeper  layers.  They 
should  be  applied  generously  and  well  rubbed  in.  Care  should 
be  taken  to  avoid  irritating  the  conjunctiva  when  applying 
in  the  region  of  the  eyes.  Application  may  be  made  imme- 
diately after  cleaning  the  skin,  and  repeated  daily  for  four  to 
six  days,  followed  by  another  thorough  cleansing.  This 
course  of  treatment  must  be  continued  with  three  or  four- 
day  intermissions  until  itching  disappears.  Prevent  the 
animal  from  licking  the  applications  by  muzzling  or  the 
addition  of  a  bitter  substance  such  as  aloes.  Many  remedies 
have  been  used  to  destroy  the  mites.  The  following  give 
good  results  and  are  least  objectionable. 

Sulphur  ointment  is  one  of  the  most  common  preparations 
used  for  the  sarcoptes  mite.  It  gives  better  results  when 
used  against  the  Notoedres  cati  of  the  cat  and  Cnemido- 
coptes  mutans  of  the  chicken.  A  more  active  preparation 
must  be  used  on  the  dog.  The  following  mixture  is  recom- 
mended : 

I* — Creolini 30.0 

Phenol 15.0 

Sulphur  flor 60.0 

Ol.  terebinth 120.0 

Aq.  ammonii 90.0 

Ol.  lini 600.0 

Kerosene 1200.0 

Misce  et  fiat  emulsio. 


480  PARASITIC  SKIN  DISEASES 

Daily  application  may  be  made  over  small  areas  but  in 
generalized  cases  only  a  part  of  the  body  should  be  treated 
at  a  time.  The  mixture  is  irritating,  hence  when  the  animal 
shows  signs  of  exhaustion  its  use  should  be  discontinued  for 
a  few  days.  Other  preparations  used  are  balsam  of  Peru  in 
alcohol  (5  to  10  per  cent.),  creolin  ointment,  styrax  ointment 
(5  per  cent.). 

Demodex  Mite.— Etiology.— Demodectic  scabies  is  pro- 
duced by  the  parasite,  Demodex  follicutorum.  This  parasite 
lives  in  the  hair  follicles  and  sebaceous  glands,  locations 
favoring  much  irritation  and  making  treatment  most  difficult. 
The  demodex  mite  is  decidedly  different  in  appearance  from 
the  sarcoptes.  Its  body  is  elongated,  and  provided  with 
eight  short  legs  emanating  from  its  anterior  third.  The 
posterior  part  tapers  to  a  blunt  point.  The  head  is  short 
and  thick.  The  total  length  is  about  six  times  the  body 
width.  Some  one  of  the  many  varieties  may  be  found  on  all 
kinds  of  small  animals.  The  dog,  however,  is  the  principal 
sufferer.  Cats  are  rarely  attacked. 

Pathology.— The  skin  in  mild  cases  shows  only  slight  inflam- 
matory symptoms.  In  severe  cases  the  skin  is  greatly 
thickened,  and  shows  intact  or  ruptured  pustules.  In  micro- 
scopic cross-sections  the  parasite  is  found  within  the  glands 
and  follicles. 

Symptoms.— The  early  indications  of  demodex  mange  are 
the  presence  of  isolated  inflammatory  areas  from  one-half  to 
two  inches  in  diameter.  The  hair  covering  them  appears  as 
though  clipped  off  closely.  The  condition  gradually  spreads 
and  may  cover  the  entire  body.  Occasionally  demodex 
mange  occurs  in  the  well  named  squamous  form.  In  this 
there  is  only  slight  irritation  and  no»  marked  inflammatory 
symptoms.  The  hair  becomes  thin,  and  gray-white  scales 
cover  the  skin.  This  condition  may  continue  without  change 
for  months  especially  when  the  dog  is  brushed  and  bathed 
frequently  as  may  be  done  with  house  pets.  The  disease 
makes  progress  by  a  gradual  peripheral  spread  over  the  skin, 
or  less  often  by  the  occurrence  of  new  isolated  areas  over  the 
body.  The  skin  thickens,  pustules  develop  and  erupt  form- 
ing crusts;  the  hair  falls  out.  Emaciation  follows  and  the 


SCABIES—MANGE—RED  MANGE— ITCH  481 

animal  becomes  cachectic  and  exhausted.  Pruritus  is  present 
from  the  beginning  and  frequent  scratching  and  rubbing  are 
the  most  noticeable  symptoms. 

Diagnosis.— A  positive  diagnosis  can  be  made  only  by 
identifying  the  parasite  under  the  microscope.  As  these 
parasites  live  deep  in  the  skin  it  is  necessary  to  make  the 
.scraping  accordingly. 

Prognosis.— Favorable  if  local  and  treated  in  the  early 
stages;  unfavorable  if  generalized.  Recovery  may  be 
obtained  by  proper  treatment  which  may  require  eight  to 
ten  weeks.  In  severe  cases  with  symptoms  of  cachexia  and 
exhaustion  present  the  treatment  usually  hastens  the  fatal 
termination. 

Treatment.  —Mild  localized  cases  may  be  treated  without 
washing  or  brushing.  Generalized  cases  with  crust  forma- 
tions require  thorough  cleansing  with  soap  or  alkaline  solu- 
tions and  all  hair  removed.  As  the  demodex  live  deep  in  the 
skin  glands  it  is  evident  that  severe  and  vigorous  treatment 
is  required  to  effect  recovery.  Every  parasiticide  known  has 
been  used  either  alone,  or  in  combination  but  without 
success.  One  mixture  deserves  mention  as  many  cases  have 
recovered  after  its  prolonged  use.  It  is  not  toxic,  and  will 
not  be  licked  off. 

I}— C'reolini 30.0 

Phenol 15.0 

Sulphur  flor 60.0 

Ol.  terebinth  120.0 

Aq.  ammonii 90.0 

Ol.  lini 600.0 

Kerosene 1200.0 

Mi  see  et  fiat  emulsio. 

This  may  be  applied  daily  over  diseased  areas.  If  the 
entire  body  is  affected,  only  one-third  of  it  should  be  treated 
at  a  time.  A  thorough  skin  washing  should  be  given  once  a 
week.  If  the  animal  shows  ill  effects  of  the  treatment  after 
a  time,  it  may  be  discontinued  for  a  few  days  and  a  dressing 
of  oil  substituted.  Avoid  the  eyes  in  applying  it;  keep  the 
patient  in  a  warm  place.  Feed  well  and  stimulate  the  appe- 
tite with  tonics.  A  saturated  solution  of  balsam  of  Peru  in 

31 


482  PARASITIC  SKIN  DISEASES 

alcohol  (1.0-5.0)  has  given  good  results  but  the  odor  is  objec- 
tionable in  house  pets.  Animals  being  treated  with  oily  or 
fatty  preparations  must  be  kept  in  a  warm  place  as  the  heat 
radiation  from  the  body  is  increased  by  such  application. 

DERMATOMYCOSIS. 

Vegetable  Parasitic  Disease  of  the  Skin. 

Definition.— A  communicable  disease  of  the  skin  produced 
by  fungi,  somewhat  similar  to  ordinary  molds.  Several 
species  of  fungi  have  been  found  to  produce  skin  diseases. 
From  the  standpoint  of  clinical  diagnosis  they  may  be  divided 
into  two  classes.  Identification  is  possible  only  by  their 
cultural  characteristics.  These  parasites  occur  on  the  skin 
in  the  form  of  mycelia  or  filaments  which  may  or  may  not 
be  segmented.  From  these  segments  spores  are  formed  which 
in  turn,  germinate  to  form  new  mycelia.  The  spores  are 
round  or  oblong  and  under  the  microscope  strongly  refract 
the  light. 

Examination.— The  mycelia  and  spores  are  extremely 
small  and  require  high  power  magnification.  A  smear  slide 
made  with  scrapings  from  the  crusts  or  scabs,  examined  under 
high  power,  will  show  them  as  small,  rounded  spores  either 
scattered  or  in  chains.  The  segmented  mycelia  may  also  be 
recognized.  It  is  advisable  to  pull  a  few  hairs  from  the  dis- 
eased area  and  examine  near  the  roots  for  masses  of  fungi. 

HERPES  TONSURANS. 

Ringworm.     Red  Itch. 

Etiology.— This  disease  is  produced  by  the  Trichophyton 
tonsurans  or  other  similar  forms  of  fungi  which  are  usually 
classed  as  the  trichophyta. 

Pathology.— The  fungi  develop  around  the  shaft  of  the 
hair  and  extend  down  into  the  follicle  but  not  to  the  root. 
The  hair  becomes  brittle,  splits  and  breaks  off  close  to  the 
skin.  The  enormous  number  of  spores  that  grow  in  the 
follicles  and  beneath  the  epidermis  set  up  inflammation, 
especially  in  the  parts  of  the  skin  thickly  covered  with  hair. 


HERPES  TONSURANS  483 

Symptoms.— Ringworm  occurs  in  all  small  animals  but 
is  most  common  in  the  dog.  The  lesions  may  be  found  on 
any  part  of  the  skin  but  usually  appear  on  the  head  and 
legs,  parts  frequently  in  contact  with  objects  harboring  the 
parasite. 

Ringworm  is  characterized  by  small,  well  defined,  circular 
areas.  By  increasing  in  size  and  number  they  merge  to 
form  irregular,  large  patches.  At  first  slightly  reddened, 
these  areas  soon  are  covered  with  dirty,  gray  crusts  or 
scabs.  Irritation  is  variable,  at  times  very  intense  inducing 
scratching  and  rubbing  which  remove  the  crusts  and  leave 
the  surface  raw  and  bleeding.  Small  nodules  are  some- 
times seen,  due  to  swollen  hair  follicles.  Most  of  the  hair 
is  broken  off.  On  those  areas  where  pruritus  is  absent  the 
crusts  remain,  become  thicker  and  agglutinate  the  hairs. 
Suppuration  proceeds  beneath  the  crusts  and  an  offensive 
odor  is  emitted.  In  general  the  condition  is  less  severe  and 
more  superficial  than  sarcoptic  scabies,  but  the  spread  is 
more  rapid.  When  the  condition  involves  a  greater  part  of 
the  body  general  disturbance  follows.  Suppuration  beneath 
the  scabs  permits  of  the  absorption  of  toxins  which  poison, 
and  the  constant  irritation  exhausts  the  animal. 

Diagnosis.— Accurate  diagnosis  is  possible  only  with  the 
microscope.  The  well  defined,  circular  areas  covered  with 
short  hairs  in  most  cases  and  the  rapid  progress  may  be  indic- 
ative. 

Prognosis.— Very  good  if  treated  before  the  animal  becomes 
emaciated  and  exhausted.  Spontaneous  recovery  is  exceed- 
ingly rare. 

Treatment.— In  a  generalized  case,  except  in  short  haired 
animals,  remove  all  of  the  hair.  Where  only  isolated  spots 
occur  clip  the  hair  well  back  from  the  margin.  Remove  the 
crusts,  softening  them  if  necessary  with  lard,  oil  or  ointments. 
Cleanse  the  skin  by  washing  with  a  soapy  or  alkaline  (sodium 
carbonate)  solution. 

This  parasite  is  not  very  resistant,  hence  most  of  the  anti- 
parasitic  preparations  give  good  results.  Inasmuch  as  the 
fungus  is  somewhat  susceptible  to  fats  the  medicinal  agents 
should  be  applied  in  oils  or  ointments.  These  prevent  fur- 


484  PARASITIC  SKIN  DISEASES 

ther  spread  of  the  fungus  and  in  addition  are  soothing  and 
protective  to  the  irritated  skin. 

Creolin  or  iodin  ointment  is  recommended  and  gives 
good  results.  These  may  be  applied  once  daily  for  a  week 
followed  by  a  thorough  cleansing.  Continued  treatment 
depends  upon  the  appearance.  Small  areas  may  be  treated 
with  pure  tincture  of  iodin,  two  or  three  applications  a  week. 
A  strong  solution  of  bichlorid  of  mercury  (1-500)  is  also 
quite  efficient.  Careful  inspection  must  be  made  frequently 
for  new  disease  areas.  Powdered  aloes  will  prevent  the 
patient  licking  off  the  ointment. 

If  other  animals  are  kept  near  care  must  be  taken  to 
prevent  the  spread  of  the  disease.  All  removed  hair,  crusts, 
also  the  bedding  used  by  the  patient,  should  be  destroyed. 
Cleanse  the  sleeping  quarters  with  a  strong  solution  of 
bichlorid  of  mercury.  Restrict  their  range  to  prevent  con- 
tamination of  runways  and  yards.  Cleanse  and  disinfect 
all  utensils  and  other  articles  used  about  them. 

FAVUS. 

Honeycomb  Ringworm.     Comb  Disease.     White  Comb. 

Etiology.— This  disease  is  due  to  a  fungus,  the  Achorion 
schonleinii.  It  occurs  chiefly  in  cats,  mice  and  rats,  but  also 
in  dogs  and  rabbits.  The  type  affecting  birds  is  caused  by  a 
special  fungus  similar  to  the  trichophyton  and  designated 
as  the  Lophophyton  gallinarum,  commonly  called  "white 
comb"  or  "comb  disease." 

Pathology.— The  fungus  localizes  itself  in  a  hair  follicle.  As 
it  develops  it  gradually  extends  over  the  surrounding  skin 
forming  a  yellowish  crust.  Immediately  beneath  it  the  skin 
atrophies,  becomes  moist  and  around  the  edge  of  the  lesion 
appears  an  inflammatory  swelling  producing  a  cup-shaped 
depression  at  the  bottom  of  which  the  crust  is  attached. 
This  crust  is  composed  mostly  of  the  fungus  material,  mixed 
with  hair  or  epithelial  masses. 

Symptoms.— Fa vus  usually  appears  about  the  head  espe- 
cially in  cats  but  the  feet  are  also  commonly  affected.  This 


FAVUS  485 

is  clue  to  the  infection  being  acquired  from  mice  and  rats 
affected  with  the  disease.  In  dogs  and  cats  the  lesions  appear 
as  a  sulphur-yellow,  circular  mass  depressed  in  the  center 
and  free  at  the  edges,  the  size  of  a  ten-cent  piece.  A  number 
of  areas  in  contact  do  not  merge  but  encroach  upon  one 
another  producing  irregular  shaped  figures.  In  birds  the 
crusts  are  thinner  than  in  mammals  and  the  areas  tend  to 
coalesce  until  a  large  surface  is  formed  covered  by  a  creviced 
crust.  When  feathered  parts  of  the  skin  are  invaded  the 
feathers  fall  out.  The  disease  may  extend  all  over  the  body. 

Pruritus  is  rare  and  it  is  seldom  that  the  crusts  are  rubbed 
or  scratched  off. 

Diagnosis.  — The  presence  of  the  sulphur-yellow,  fa  vie  cup 
and  slow  growth  make  it  easily  recognized.  In  birds  the 
mouldy  appearance  and  progressive  growth  indicate  the 
character  of  the  disease. 

Prognosis.— The  prognosis  is  favorable;  the  disease  may 
heal  spontaneously.  If  far  advanced  and  generalized  in 
birds  it  is  usually  fatal. 

Treatment.— Remove  the  crusts  with  a  blunt  instrument 
damaging  the  skin  as  little  as  possible.  Wash  or  otherwise 
cleanse  the  skin  and  apply  tincture  of  iodin  diluted  well  with 
alcohol.  Bichlorid  of  mercury  (1-500)  is  equally  good. 
Dilute  silver  nitrate  solution  (2  per  cent.)  may  also  be  used. 
I'suallv  5  to  0  dailv  treatments  are  sufficient. 


PART  XI. 


DISEASE  OF  THE  EAR, 

Examination.— The  external  ear  (concha)  in  dogs  varies 
greatly  in  size  depending  upon  the  breed  and  size  of  the 
animal.  It  is  easily  examined  by  direct  inspection.  Careful 
examination  should  be  made  for  wounds,  bruises,  hematomas 
and  scars.  Long  hairs  in  certain  breeds  (cocker  spaniels) 
will  interfere  to  a  certain  degree  with  the  examination.  In 
cats  and  rabbits  an  inspection  of  the  external  ear  can  be 
made  without  difficulty.  Note  sensitiveness  to  manipulation. 

The  external  ear  canal  can  be  inspected  in  ordinary  day- 
light but  the  examination  is  facilitated  by  the  use  of  an  ear 
speculum  and  mirror  to  reflect  the  light  to  the  bottom  of  the 
canal.  The  operator  should  exercise  care  in  the  examina- 
tion by  either  muzzling  or  taping  the  animal.  Examine 
the  external  canal  for  inflammation,  tumors,  foreign  bodies, 
cerumen  accumulations  and  parasites. 

WOUNDS  OF  THE  EAR. 

Various  degrees  of  wounds  are  observed  involving  the 
concha.  Bites  from  other  animals  are  the  most  common 
causes.  The  lesion  may  be  a  simple  scratch  or  cut  in  the  skin 
or  the  entire  structure  may  be  split  in  various  degrees.  Exten- 
sive wounds  are  often  found  in  all  the  animals.  Constant 
shaking  the  head  especially  in  long  eared  dogs  often  leads  to 
extensive  injury  to  the  outer  margin  of  the  concha.  This 
mode  of  injury  is  often  brought  about  by  the  parts  being 
irritated  by  insects  (flies)  and  parasites  (Otodectes  cynotis). 


488  DISEASES  OF   THE  EAR 

In  some  animals  the  thick,  heavy,  cartilaginous  conchal  base 
may  be  fractured  by  external  violence. 

Symptoms.— In  dogs  careful  shaking  of  the  head  and  hold- 
ing it  to  one  side,  crying  and  evincing  pain  when  the  ear 
comes  in  contact  with  objects  are  often  noted.  Careful 
inspection  will  reveal  the  nature  and  extent  of  the  wound. 

Prognosis.— Favorable  in  most  cases.  In  dogs  with  long 
ears,  and  when  the  wounds  are  extensive,  it  is  difficult  to 
prevent  their  shaking  the  head  and  aggravating  the  wound, 
which  will  materially  influence  the  healing  process. 

Treatment.— In  recent  wounds  the  edges  should  be  care- 
fully cleaned,  straightened  with  the  scissors  if  necessary,  and 
approximated  with  sutures.  To  facilitate  union  in  some  cases 
it  is  necessary  to  bandage  the  ears  over  the  top  of  the  head 
using  a  cap  to  cover  the  entire  head  to  hold  them  in  place. 
Frequent  dressing  (twice  daily)  is  advisable.  Apply  boric 
acid  powder  as  an  antiseptic  and  to  prevent  adhesions  of  the 
parts  by  the  secretions.  When  extensive  tearing  of  the  entire 
structure  is  found,  it  is  necessary  in  some  cases  to  remove 
a  portion  of  the  ear-flap.  In  this  case  it  is  best  to  remove  a 
similar  portion  of  the  normal  ear  so  that  the  ears  will  be 
symmetrical  after  healing  takes  place. 

ULCERATION  OF  THE  CONCHA. 

This  condition  occurs  most  frequently  in  dogs  and  espe- 
cially in  the  breeds  possessing  long  pendent  ears.  The  ulcer- 
ous process  is  found  in  nearly  all  cases  on  the  edge  of  the 
concha. 

Etiology.— Occurs  in  most  cases  from  injuries  with  more 
or  less  constant  shaking  of  the  head.  The  irritation  thus 
produced  keeps  up  the  injury  and  interferes  with  union  of  the 
parts.  Ulceration  is  most  frequent  during  the  fly  season. 
The  irritation  produced  by  the  flies  causes  the  animal  to 
shake  its  head  violently,  injuring  still  further  the  wounded 
parts.  This  is  observed  especially  in  older  animals.  Other 
diseases  such  as  otitis  and  eczema  produce  it  in  a  similar 
manner.  Hunting  dogs  are  frequently  affected  from  the  ears 
becoming  injured  while  going, through  brush,  briers,  etc. 


HEM  ATOM  A  489 

Symptoms.  — The  condition  is  easily  diagnosed  as  the  ulcera- 
tion  is  observed  on  or  near  the  edge  of  the  ear-flap.  The 
constant  shaking  and  holding  the  head  to  one  side  are  the 
most  pronounced  symptoms.  On  examination  the  part  is 
usually  found  edematous,  hot,  painful  and  more  or  less  hemor- 
rhage present.  Dried  blood  will  be  found  on  the  margins  of 
the  ear-flap.  Should  the  fissuring  be  deep  it  may  be  infected 
with  pus. 

Prognosis.— Should  not  be  made  very  favorable  as  there  is 
usually  some  loss  in  the  ear-flap,  which  in  some  animals 
would  be  serious  by  disfiguring.  Further,  the  condition  is 
often  resistant  to  treatment.  The  prognosis  is  less  favorable 
in  old  animals. 

Treatment.  —  The  part  should  be  first  washed  with  an  alka- 
line soap,  to  remove  all  dried  crusts  and  other  accumula- 
tions. Apply  silver  nitrate  solution  (2  per  cent.)  to  stimulate 
granulation.  Follow  by  an  antiseptic  dusting  powder  (iodo- 
form;  xeroform).  One  of  the  essential  factors  is  to  protect 
the  ears  from  further  injury  and  irritation.  This  is  best  done 
by  bandaging  the  ears  over  the  top  of  the  head  and  using  a 
head  cap.  Frequent  dressing  with  the  above  materials  is 
advisable.  If  the  condition  is  due  to  insect  bites  the  animal 
should  be  protected.  In  hunting  dogs  the  ears  should  also  be 
protected  from  further  injury  by  light  head  cap  or  bandage. 

HEMATOMA. 

Hematomas  are  frequently  found  in  dogs  with  long  pendent 
ears.  Other  animals  are  seldom  affected. 

Etiology.— This  condition  is  brought  about  through  trau- 
matism.  Very  often  it  occurs  secondary  to  otitis  or  ulcera- 
tion  of  the  concha.  The  hematoma  results  from  a  rupture 
of  the  capillaries  and  an  extravasation  of  blood  or  serum 
between  the  skin  and  conchal  cartilage. 

Symptoms.— As  a  rule  hematoma  develops  suddenly.  The 
animal  holds  the  head  sideways,  the  affected  ear  down  and 
frequently  shakes  its  head.  The  ear-flap  is  sensitive  to  the 
touch,  and  a  distinct  bulging  of  the  skin  on  the  upper  or 
lower  surface  is  noted;  both  surfaces  may  be  involved.  The 


490  DISEASES  OF  THE  EAR 

enlargement  will  be  found  sensitive,  hot  and  fluctuating. 
When  of  older  standing  the  acute  symptoms  will  be  absent 
and  some  organization  of  tissue  will  be  found  around  the 
margins  of  the  enlargement. 

Diagnosis.— This  is  made  on  the  location  of  the  enlarge- 
ment, the  fluctuation  and  the  absence  of  marked  inflamma- 
tory symptoms. 

Prognosis.— Favorable  in  most  cases. 

Treatment.— Several  modes  of  remedial  procedure  have 
been  used.  The  principles  involved  in  the  treatment  in 
order  to  be  successful  consist  in  the  evacuation  of  the  con- 
tents, maintaining  the  separated  tissues  in  contact  so  that 
union  can  take  place,  and  keeping  the  ear-flap  quiet.  This 
is  best  accomplished  perhaps  by  the  following:  Shave  the 
hair  over  the  area  and  thoroughly  disinfect  the  surface  by 
painting  with  iodin.  Make  the  incision  at  the  most  pendent 
portion  of  the  enlargement  and  of  sufficient  length  to  permit 
all  the  serum,  blood  clots  and  organized  tissue  to  be  removed 
completely.  Press  out  all  the  fluid  and  bring  the  separated 
tissues  in  contact  with  the  cartilage.  Retain  in  contact  by 
suturing  with  interrupted  sutures  which  pass  through  the 
concha.  The  sutures  should  be  placed  so  that  the  skin  is 
held  in  intimate  contact  with  the  cartilage  at  all  points.  A 
dressing  of  iodoform  should  be  applied  and  the  ears  band- 
aged over  the  top  of  the  head  to  ensure  a  quiet  position  and 
sufficient  external  pressure  to  prevent  any  further  collection 
of  serum.  The  dressing  should  be  changed  daily.  In  a  week 
or  ten  days  the  sutures  may  be  removed  and  the  bandage 
discontinued.  This  method  must  be  rather  rigidly  adhered 
to  if  good  results  are  expected.  Other  methods  such  as 
removing  the  collection  of  material  and  injecting  Lugol's 
solution  or  tincture  of  iodin  have  been  used. 

OTITIS  EXTERNA.     OTORRHEA. 

Involvement  of  the  internal  portion  of  the  external  ear 
with  various  degrees  of  inflammation  is  very  common  in 
dogs  with  long  pendulous  ears  and  in  rabbits  from  parasitic 
invasion.  It  is  frequently  unilateral,  but  in  a  number  of 


OTITIS  EXTERNA—OTORRHEA  491 

cases  both  ears  are  involved.  Middle  aged  or  older  animals 
are  affected  most  commonly. 

Etiology.— There  are  a  variety  of  things  having  to  do  with 
the  cause  of  this  condition:  (a)  Accumulations  of  cerumen 
and  dirt  are  common  causative  factors.  These  substances 
cause  irritation  to  the  skin  resulting  in  inflammation  and 
pyogenic  infection.  Animals  with  long  pendent  ears  tend  to 
retain  these  materials  and  decomposition  and  infection  are 
thus  formed,  (b)  Retention  of  debris  from  acute  attacks 
leads  to  further  irritation  and  often  produces  a  chronic  form 
of  the  disease  with  considerable  thickening  of  the  tissues. 
(c)  In  young  animals  the  condition  is  frequently  associated 
with  distemper.  Secondary  infection  during  the  progress 
of  the  disease  involves  the  auditory  canal,  (d)  Occasionally 
in  dogs,  but  more  commonly  in  rabbits,  invasion  with  the 
parasite  Otodectes  cynotis  occurs.  In  this  case  the  entire 
canal  is  involved,  even  the  internal  ear.  The  parasites  pro- 
duce extensive  irritation  and  an  aggravated  form  of  the  dis- 
ease, (e)  May  result  from  ulceration  of  the  concha  and 
hematoma  by  extension  of  the  process  from  continued 
irritation. 

Symptoms.— In  the  early  stages  and  when  the  condition 
is  acute  the  animal  shows  restlessness,  shakes  and  scratches 
its  head  and  ears  with  its  paws  almost  continuously,  and 
rubs  them  against  objects.  Along  the  margins  of  the  ear  is 
often  noticed  a  blood-mixed  discharge.  Direct  examination 
reveals  the  ear  to  be  hot,  sensitive  and  the  surface  covered 
with  a  thick  waxy  secretion.  Owing  to  the  swelling  of  the 
skin  and  contiguous  tissues  an  ear  speculum  is  often  neces- 
sary in  order  to  examine  thoroughly  the  lower  portion  of  the 
canal.  During  the  later  stages  ulceration  takes  place  and 
more  or  less  extensive  pus  formation  is  found.  Palpating 
the  base  of  the  concha  and  exerting  some  pressure  a  thick, 
dark  colored  discharge  will  be  forced  out.  The  head  is 
usually  held  in  a  fixed  position,  and  if  one  side  only  is  affected 
it  will  be  held  to  that  side.  The  condition  may  produce  tem- 
porary or  permanent  deafness.  In  rabbits,  when  due  to 
parasites,  nervous  symptoms  are  very  common.  This  has 
been  observed  in  dogs. 


492  DISEASES  OF  THE  EAR 

In  the  chronic  form  there  will  be  extensive  proliferation 
of  connective  tissue  projecting  out  into  the  auditory  canal. 
The  mass  is  irregular  in  form,  often  pedunculated,  and  will 
in  some  cases  close  the  entire  opening. 

Diagnosis.— The  characteristic  discharge  and  other  symp- 
toms as  described  make  the  diagnosis  simple.  Examination 
of  the  discharge  should  be  made  carefully  to  determine 
whether  parasites  are  present  or  not. 

Prognosis.— In  the  acute  form,  favorable.  After  extensive 
proliferation  of  tissue  has  taken  place  the  prognosis  is  less 
favorable  and  recovery  is  difficult. 

Treatment.  — Both  ears  should  be  examined  carefully  to 
determine  the  degree  of  involvement.  It  is  essential  in  the 
h'rst  place  to  remove  all  dirt  and  cerumen  which  has  accumu- 
lated. This  is  best  accomplished  by  taking  pledgets  of 
cotton  or  gauze  on  a  dressing  forceps,  saturate  them  in  ether, 
thoroughly  swabbing  out  the  whole  canal  until  all  the  debris 
is  removed.  In  this  cleansing  process  all  of  the  small  inter- 
stices between  the  swollen  masses  should  be  opened  and 
swabbed.  The  ether  solution  is  necessary  in  order  to  dis- 
solve the  cerumen.  With  the  scissors  cut  away  all  super- 
fluous hair  in  the  canal.  Dry  cotton  or  gauze  should  then 
be  used  in  making  the  surface  perfectly  dry  and  also  to  remove 
any  excess  of  ether  which  might  be  retained.  An  antiseptic 
powder  (boric  acid;  xeriform;  tannoform)  is  worked  down 
carefully  into  the  canal  to  produce  antiseptic  action  and  to 
prevent  the  secretions  adhering  to  the  skin  surface.  This 
treatment  should  be  applied  daily  until  the  inflammation 
and  swelling  subside. 

In  the  chronic  form  with  proliferation  of  tissue  and  ulcera- 
tion  the  canal  should  be  cleaned  as  described  and  the  surface 
thoroughly  cauterized  with  stick  silver  nitrate.  To  prevent 
undue  cauterization  follow  by  salt  solution.  After  the  ulcera- 
tive  process  is  reduced  antiseptic  treatment  can  be  substi- 
tuted. Several  weeks'  treatment  is  often  required  in  this 
form.  Should  the  animal  continue  to  shake  the  head  and 
aggravate  the  condition  a  head  cap  may  be  employed  for  a 
few  days.  In  long-eared  dogs  the  ears  should  be  examined 
every  few  weeks  as  there  is  danger  of  recurrence.  Should 
parasites  be  present  treat  with  antiparasitics. 


TUMORS—NEOPLASMS  OF  THE  EAR  493 


OTITIS  MEDIA  AND  INTERNA. 

This  condition  is  not  very  common  in  small  animals.  It 
occurs  most  frequently  in  rabbits  from  parasitic  invasion. 
The  diagnosis  is  difficult  as  the  condition  is  usually  compli- 
cated with  involvement  of  the  auditory  nerve,  or  pachy- 
meningitis.  Xo  treatment  is  of  any  value.  Sedatives  would 
be  indicated  to  control  the  nervous  symptoms. 


TUMORS.     NEOPLASMS  OF  THE  EAR. 

Xeoplastic  formations  are  not  so  common  in  this  location. 
Papillomata  occur  commonly  on  the  inner  surface  of  the 
outer  ear,  but  malignant  tumors  are  rarely  seen.  Distentions 
of  the  sebaceous  ducts  are  occasionally  seen. 

Papillomata.— These  are  found  on  the  margins  of  the  skin 
or  in  some  portion  of  the  vestibule  of  the  ear  and  appear 
as  single  or  multiple  excrescences.  They  are  fiat,  oval  or 
cauliflower-like  in  their  growth.  The  surface  is  smooth  or 
roughened  and  frequently  covered  by  a  thick,  greasy  material. 

Symptoms. — The  presence  of  tumors  often  leads  to  irrita- 
tion and  may  produce  otitis.  (See  Otitis.)  On  examination 
they  are  observed  either  as  isolated  single  tumors  or  multiple 
tumors  and  with  smooth  or  irregular  surface.  They  are 
often  pedunculated  and  stand  out  prominently.  AVhen  in 
the  lower  portion  of  the  canal  they  may  completely  occlude 
the  opening.  The  diagnosis  can  be  made  positive  by  micro- 
scopic examination. 

Prognosis.  —  Favorable. 

Treatment. —Operation  is  advisable.  When  large  numbers 
are  present  the  animal  should  be  anesthetized  and  the  entire 
surface  cleaned  and  disinfected.  The  tumors  are  removed 
as  close  to  the  base  as  possible,  best  by  the  scissors.  The 
base  should  be  cauterized  by  the  actual  cautery.  The  after- 
treatment  consists  in  keeping  the  part  clean  and  using  an 
antiseptic  astringent  powder  (tannoform).  If  necessary  a 
head  bandage  or  cap  may  be  used  to  keep  the  ear  quiet. 


494  DISEASES  OF  THE  EAR 

Sebaceous  Tumors  or  Cysts.— These  are  recognized  by 
their  rounded,  well-defined  appearance,  absence  of  inflam- 
matory symptoms,  and  the  character  of  the  contents. 

Treatment.— The  cyst  should  be  opened  well,  all  of  the 
secretions  pressed  out,  and  tincture  of  iodin  applied  to 
destroy  the  gland.  It  may  be  necessary  in  some  cases  to 
open  into  the  gland  and  destroy  it  by  silver  nitrate  or  the 
actual  cautery. 

PARASITES  IN  THE  EAR. 

In  the  rabbit  and  dog  the  Otodectes  c^notis  and  the 
Dermatophagus  canis  are  frequently  found  producing  a  more 
or  less  intensive  form  of  otitis. 

Symptoms.— During  the  early  stage  of  invasion  the  symp- 
toms are  n6t  very  pronounced.  Later  as  the  parasites 
increase  in  numbers  and  they  extend  farther  down  into  the 
canal,  the  patient  carries  its  head  at  an  angle,  whines,  and 
rubs  its  ears  against  objects.  Rabbits  often  show  marked 
nervous  symptoms  from  the  irritation  of  the  internal  ear  and 
auditory  nerve  direct.  On  examination  there  will  be  found  a 
similar  condition  as  in  otitis.  Tiny  white  or  reddish  specks 
will  be  visible  in  the  discharge  and  when  examined  under  a 
low  power  microscope  or  reading  glass,  the  parasites  are  seen 
and  recognized  without  difficulty. 

Diagnosis.— This  is  made  positive  by  the  presence  of  the 
parasites  in  the  discharge. 

Prognosis.— Favorable.  Most  cases  will  recover  unless 
nervous  symptoms  are  present  indicating  the  involvement 
of  the  internal  ear.  Such  cases  should  be  considered  hopeless, 
especially  in  rabbits. 

Treatment. — Local  applications  have  proved  quite  satis- 
factory in  these  cases.  Remove  all  crusts,  secretions  and 
debris  with  a  solution  of  alcohol  or  ether.  Dry  the  surface 
by  using  a  swab  of  cotton  or  gauze.  Apply  paraffin  oil  to 
the  entire  surface,  or  a  solution  of  carbolic  acid  (5  per  cent.) 
in  paraffin  oil.  Other  oleaginous  compounds  may  be  used. 
Thoroughness  in  the  application  is  important  in  order  to 
destroy  all  parasites  present.  Daily  applications  are  advis- 
able. 


EAR  FISTULA  495 


DEAFNESS. 

Etiology.— This  condition  is  observed  from  diseases  affecting 
the  internal  ear,  from  closure  of  the  external  canal  or  it  may 
be  congenital.  Paralysis  of  the  auditory  nerve  may  be  the 
result  of  general  infection  (distemper)  or  ptomain  poisoning. 
Deafness  is  noted  very  commonly  in  puppies,  sometimes 
several  in  a  litter  will  be  affected.  This  no  doubt  is  due  to 
improper  development  of  the  auditory  nerve  or  other  struct- 
ures of  the  internal  ear.  The  condition  is  acquired  in  some 
cases  from  disease  processes  and  infection  extending  to  the 
internal  ear.  Complete  closure  of  the  external  canal  will 
produce  at  least  a  temporary  deafness. 

Symptoms.— The  most  pronounced  symptom  is  failure  to 
obey  commands.  Puppies  deaf  from  birth  do  not  bark  or 
make  any  definite  sounds.  In  congenital  deafness  the 
examination  will  reveal  nothing  abnormal  with  the  external 
ear.  In  acquired  deafness  in  some  cases  the  cause  may  be 
found,  such  as  closure  of  the  external  canal. 

Prognosis.— Unfavorable  in  all  cases  of  congenital  origin 
or  in  cases  due  to  external  infection  or  parasites  entering  and 
destroying  the  internal  ear.  It  is  favorable  in  some  cases 
of  closure  of  the  external  canal  with  cerumen  or  tumor 
formation. 

Treatment.— In  congenital  deafness  no  treatment  seems  to 
be  of  any  value.  If  the  deafness  is  due  to  paralysis  of  the 
auditory  nerve  small  doses  of  strychnin  would  be  recom- 
mended (0.001  once  daily).  Examination  of  the  external 
meatus  should  be  made  and,  if  closed,  it  should  be  dilated 
and  the  cause  removed. 


EAR  FISTULA. 

Etiology. — Dentigerous  cysts  are  occasionally  found  in  the 
temporal  region  and  have  their  opening  in  the  auditory  canal. 
Wounds  of  the  cartilage  of  the  ear,  either  from  sharp  objects 
penetrating  this  region  or  from  other  causes  may  lead  to  a 
fistulous  opening. 


496  DISEASES  OF  THE  EAR 

Symptoms.— The  presence  of  a  thick,  white,  glutinous  dis- 
charge either  into  the  auditory  meatus  or  to  the  outside 
should  be  regarded  with  suspicion  and  the  parts  thoroughly 
examined.  Often  the  hair  will  be  removed  at  the  point  of 
discharge  and  the  material  collect,  become  dried  and  form 
crusts.  Pressure  over  the  region  will  often  reveal  the  point 
of  discharge.  The  introduction  of  a  small  flexible  probe  will 
make  the  diagnosis  positive.  There  is  in  nearly  all  cases 
some  enlargement  in  the  tissues  adjacent  to  the  fistula. 

Prognosis. — All  fistulse  involving  the  cartilage  of  the  ear 
should  not  be  considered  in  favorable  light.  As  the  process 
is  a  progressively  destructive  one,  healing  is  difficult. 

Treatment.— The  part  should  be  shaved  and  cleansed 
thoroughly.  Introduce  a  flexible  probe  to  determine  the 
extent  of  the  fistula  and  the  tissue  invaded.  A  free  opening 
is  made  and  all  necrotic  tissue  removed.  Pack  the  wound 
with  iodin  gauze.  A  head  bandage  should  be  employed  to 
keep  the  pack  in  position.  Dress  the  wound  daily.  After 
a  few  days  it  may  be  treated  as  an  open  wound.  Some  cases 
will  require  amputation  of  the  concha.  This,  however, 
should  be  avoided  if  possible. 


PART  XII. 
DISEASES  OF  THE  EYE. 

CHAPTER  I. 
DISEASES  OF  THE  EYELIDS. 

Examination. — This  is  easily  accomplished  in  ordinary 
daylight,  or  artificial  light.  The  following  points  are  worthy 
of  consideration:  (a)  Note  the  position  of  the  lids,  whether 
they  are  normal  or  the  degree  of  abnormality  if  present. 
(6)  Note  the  reaction  of  the  lids  to  ordinary  stimuli.  This 
is  important  to  determine  different  degrees  of  sensitiveness. 
(c)  Inspect  the  margin  of  the  lids  to  determine  whether  or 
not  the  outline  is  regular,  the  presence  or  absence  of  the 
eyelashes,  (d)  Palpate  the  external  surface  for  irregularities, 
tumors,  etc.  (e)  The  condition  of  the  hair  and  surface  of  the 
eyelid  should  be  inspected  for  wounds,  denuded  areas, 
eczema,  mange,  etc.  (/)  Evert  the  lids  noting  the  resistance 
of  the  supporting  structure  and  the  condition  of  the  conjunc- 
t-ival  surface. 

Various  positions  and  reactions  of  the  lids  bear  an  impor- 
tant relation  to  different  forms  of  paralysis  and  other  diseases. 

WOUNDS  OF  THE  EYELIDS. 

Various  degrees  of  wounds  are  found  involving  the  eyelids. 
Lacerations  of  different  degrees  are  quite  common  from 
injuries  or  having  the  lids  caught  on  sharp  objects  and  torn. 
These  wounds  may  involve  only  the  margin  of  the  lids,  the 
skin  covering  the  cartilage,  or  the  entire  structure.  Even 


498  DISEASES  OF  THE  EYELIDS 

slight  wounds  on  the  lids  should  be  considered  important  on 
account  of  the  deformity,  entropion  or  ectropion  which  might 
result. 

All  wounds  should  be  examined  thoroughly  in  order  to 
determine  the  actual  condition  present.  The  wound  should 
be  cleaned  and  washed  with  boric  acid  solution  (2  per  cent.). 
Approximate  with  sutures  and  cover  the  surface  with  flexible 
collodion  or  airol  paste.  After  adhesions  have  taken  place 
the  sutures  may  be  removed  and  a  dusting  powder  applied. 
Irritating  substances  should  be  avoided  to  prevent  irritation 
to  the  eye  proper. 

When  edema  is  present  as  a  result  of  the  injury,  warm 
water  applications  are  useful.  If  abscesses  develop  they 
are  opened,  drainage  effected,  and  boric  acid  powder  applied. 
All  wounds  should  be  given  careful  attention  to  prevent 
complications  in  the  eye  itself. 

INFLAMMATION  OF  THE  EYELIDS. 

Blepharitis. 

Definition.— An  inflammation  of  the  eyelids  often  leading 
to  edema  and  suppuration  or  abscess  formation. 

Etiology.— Several  factors  have  to  do  with  producing  this 
condition:  (a)  AVounds  and  bruises  often  develop  into 
abscess  formation,  (b)  Mange,  particularly  follicular,  is  a 
frequent  cause  in  dogs;  and  sarcoptic  mange  in  cats,  (c) 
Eczema,  (d)  Exposure  to  cold  winds,  water,  etc.,  seen  in 
hunting  dogs,  (e)  Spread  of  inflammation  from  the  conjunc- 
tiva. (/)  Foreign  bodies  penetrating  the  lids,  such  as  brier 
barbs,  etc. 

Symptoms.— The  condition  is  self-evident.  An  examina- 
tion should  be  made  to  determine  the  cause  of  the  inflamma- 
tion, whether  it  is  due  to  parasites,  trauma,  eczema,  or  other 
things. 

Prognosis.— The  prognosis  is  favorable  in  most  cases  unless 
complications  involving  the  eye  are  present. 

Treatment.— Treatment  must  be  applied  to  remove  the 
cause  of  the  condition.  When  due  to  mange  mites  non- 
irritating  antiparasitic  agents  are  recommended.  Balsam 


MALPOSITION  OF   THE  EYELIDS  499 

of  Peru  has  been  very  satisfactory  for  this  purpose.  In 
eczema  the  surface  of  the  lid  should  be  freed  of  all  scales, 
and  other  accumulating  material  by  washing,  and  astringent 
antiseptics  applied  either  in  the  form  of  solution  or  dusting 
powder.  Abscesses  when  present  should  be  opened  and 
proper  drainage  afforded.  All  foreign  bodies  present  must 
be  removed  and  the  wound  treated  with  boric  acid  solution 
(2  per  cent.). 

MALPOSITION  OF  THE  EYELIDS. 

Several  malpositions  of  the  eyelids  are  met  with,  especially 
in  dogs.  Certain  breeds  of  dogs  are  predisposed  thereto  from 
their  breeding.  The  abnormalities  most  often  found  are: 
(a)  Entropion,  (b)  ectropion,  (c)  ptosis,  (d)  paralysis  of  the 
orbicularis,  and  (e)  spasm  of  the  orbicularis. 

Entropion. — Definition. — An  inversion  of  the  eyelids  either 
in  part  or  the  entire  lid.  Entropion  is  usually  complicated 
with  trichiasis  in  which  the  eyelashes  cause  more  or  less 
direct  irritation  and  injury  to  the  conjunctiva  and  cornea. 
The  condition  is  present  in  the  upper  lid  in  most  cases  on 
account  of  the  difference  in  form. 

Etiology. —It  often  results  from  the  cicatrization  of  wounds, 
chronic  inflammation  of  the  lids,  and  mange. 

Symptoms.— The  eyelid  is  turned  inwardly  against  the 
cornea.  The  eyelashes  coming  in  contact  with  the  cornea 
produce  inflammation,  suppuration  and  in  some  cases  ulcera- 
tion.  There  is  copious  discharge  of  tears,  and  pus.  The 
conjunctiva  will  be  found  reddened  and  congested. 

Prognosis. — Favorable.  The  condition  can  be  corrected 
in  the  majority  of  cases. 

Treatment.— The  injury  to  the  cornea  or  conjunctiva  may 
be  treated  with  boric  acid  solution  (2  per  cent.).  Surgical 
treatment  is  necessary  in  order  to  afford  permanent  relief. 
An  elliptical  piece  of  skin  is  removed  from  the  eyelid,  parallel 
to  the  margin  and  about  one-eighth  to  one-quarter  inch 
from  the  edge  of  the  lid. 

Entropion  forceps  are  used  to  grasp  a  sufficient  fold  of  the 
skin  so  that  when  it  is  removed  and  sutured  the  edge  of  the 


500  DISEASES  OF   THE  EYELIDS 

lid  will  be  drawn  outward  or  everted.  Care  should  be  used 
to  avoid  injury  to  the  deeper  structures  or  the  margin  of  the 
lid.  A  certain  amount  of  judgment  is  necessary  to  determine 
the  amount  of  skin  to  remove  in  each  case.  After  operation 
the  wound  is  covered  with  an  impervious  dressing  (flexible 
collodion,  airol  paste).  In  two  or  three  days  the  sutures 
may  be  removed.  Kecovery  is  prompt  and  complete  in 
most  cases.  Eye  complications  should  be  treated  according 
to  their  condition. 

Ectropion.—  Definition.—  An  eversion  of  the  eyelid  in  part 
or  the  whole  lid.  It  is  rare  in  animals.  Some  breeds  are  more 
predisposed  than  others  (bloodhounds,  pointers) .  The  lower 
lid  is  most  frequently  involved  due  to  the  lesser  curvature  as 
compared  to  the  upper. 

Etiology.— The  common  causes  of  this  condition  are: 
Wounds  with  cicatrix  formation,  lacerations  of  the  margin 
of  the  lid,  ulceration  and  abscess  formation  of  the  lid,  and 
inflammation  of  the  conjunctiva.  All  of  these  conditions 
tend  to  force  the  margin  of  the  lid  outward.  Paralysis  of  the 
facial  nerve  allows  the  lower  lid  to  fall  outward. 

Symptoms.— The  prominence  of  the  conjunctiva  of  the 
lower  lid  and  the  formation  of  a  more  or  less  deep  gutter 
from  the  separation  of  the  palpebral  edge  from  the  cornea 
are  present  in  all  cases.  The  conjunctiva  is  reddened, 
thickened,  and  there  is  a  more  or  less  constant  flow  of  tears 
down  over  the  face. 

Prognosis.— The  majority  of  cases  can  be  relieved  by 
surgical  means.  It  might  be  possible  that  the  operation  will 
need  to  be  repeated  to  properly  approximate  the  parts. 

Treatment.— In  mild  cases,  resulting  from  congestion  of 
the  conjunctiva,  relief  is  afforded  by  removing  the  cause  and 
treating  with  mild  astringents  and  antiseptics  (0.5  to  1  per 
cent,  zinc  sulphate  solution). 

When  the  conjunctiva  is  chronically  thickened  forcing 
the  palpebral  edge  outward,  it  is  advisable  to  remove  a 
portion  of  the  conjunctiva.  The  resulting  contracture  of 
the  wound  in  healing  will  bring  the  lid  back  in  position. 
Codrenin  solution  should  be  instilled  into  the  tissues  before 
operating  to  reduce  the  pain  and  control  the  hemorrhage. 


MALPOSITION  OF  THE  EYELIDS  501 

Several  operations  have  been  used  successfully  in  relieving 
this  condition.  The  removal  of  a  V-shaped  portion  of  the 
lower  lid,  leaving  the  margin  of  the  lid  free,  and  bringing  the 
edges  of  the  wound  together  with  sutures  has  been  successful. 
This  forces  the  margin  of  the  lid  upward  and  inward.  The 
amount  of  tissue  removed  will  depend  upon  the  degree  of 
correction  to  be  made. 

Another  method  frequently  employed  is  to  remove  a  tri- 
angular piece  of  skin  just  outside  of  the  external  canthus 
and  on  a  direct  line  with  the  lower  lid,  the  base  of  the  triangle 
being  upward.  Sutures  are  applied  and  the  traction  of  the 
sutures  and  the  cicatricial  tissue  formed  keeps  the  lower  lid 
pulled  upward.  In  this  case  the  size  of  the  triangle  will 
depend  on  the  degree  of  ectropion  present. 

These  operations  should  be  made  under  strict  antiseptic 
precautions  and  the  parts  protected.  If  necessary  a  head 
bandage  with  eye  protector  can  be  used. 

Ptosis. — Blepharoptosis.—  Definition.—  A  dropping  or  fall- 
ing of  the  upper  lid  so  that  it  continuously  covers  the  eye. 
It  may  occur  as  a  symptomatic  condition  in  conjunction 
with  other  local  affections,  such  as  atrophy  of  the  eyeball, 
enophthalmos,  etc. 

Etiology.— The  causes  are  various: 

(a)  It  may  be  sympathetic,  resulting  from  paralysis  of  the 
cervical  sympathetic  nerves.  Wounds  and  injuries  to  the 
nerve,  or  growths,  or  enlarged  glands,  in  its  cervical  or  intra- 
thoracic  course  will  produce  ptosis. 

(6)  Ptosis  is  often  paralytic  produced  by  a  paralysis  of  the 
muscles  of  the  upper  eyelid,  either  due  to  a  lesion  of  the 
muscle  or  its  nerve  supply. 

(c)  It  may  result  from  fracture  of  the  orbital  rim  or  process 
of  the  frontal  bone. 

(d)  Tumors  pressing  on  the  cerebrum  or  cerebellum  have 
been  known  to  cause  it. 

(e)  Ptosis  often  follows  distemper,  and  other  general  dis- 
eases. 

(/)  Very  often  tumor  formation  on  the  upper  eyelid  will 
gradually  overcome  the  muscular  action  and  drag  the  eyelid 
downward. 


502  DISEASES  OF  THE  EYELIDS 

Symptoms.— The  position  of  the  upper  eyelid,  which  hangs 
downward  and  partially  covers  the  eyeball,  is  characteristic. 
All  movements  of  the  animal  indicate  its  inability  to  move 
the  eyelid  to  any  degree.  The  most  important  thing  to  be 
considered  is  the  causative  factor,  and  the  examination  should 
be  made  to  determine  it,  if  possible. 

Treatment.— The  treatment  should  be  applied  to  remove 
the  cause.  If  sympathetic  and  the  lesion  apparent  an  attempt 
should  be  made  to  correct  it.  Very  often  the  cause  is  central 
and  cannot  be  removed.  Potassium  iodid  in  small  doses 
is  indicated.  If  of  paralytic  origin  nerve  stimulants,  such 
as  strychnin  sulphate  (0.001  daily)  may  be  tried.  Tumor 
formations  on  the  eyelid  should  be  removed  conserving  as 
much  of  the  lid  as  possible. 

Paralysis  of  the  Orbicularis  Nerve. —Definition.— Paralysis 
of  the  facial  nerve,  probably  of  central  origin,  may  be  periph- 
eral in  which  the  eye  is  held  open,  the  lower  lid  relaxed 
falling  away  from  the  eyeball. 

Etiology.— The  cause  of  paralysis  of  the  orbicularis  may 
be  wounds  or  contusions  of  the  nerve  leading  to  temporary 
or  permanent  paralysis.  When  of  central  origin  it  often 
results  from  hemorrhages  in  contact  with  the  nerve  at  the 
point  where  it  leaves  the  brain;  or  thrombus  formation  in  the 
left  posterior  cerebellar  artery  interfering  with  the  nutrition 
of  the  nucleus  of  the  facial  nerve.  Tumors  of  the  brain,  and 
chronic  lesions  resulting  from  distemper  have  also  been 
found  to  produce  it. 

Symptoms.— The  lack  of  symmetry  of  the  two  sides  of  the 
face  is  the  most  apparent  symptom  of  facial  paralysis.  The 
side  paralyzed  has  a  relaxed  and  drooped  appearance.  The 
eyelid  will  be  drooped  to  a  degree  and  cover  a  portion  of  the 
eyeball  but  cannot  be  closed  producing  a  condition  of  lag- 
ophthalmus.  There  is  a  very  noticeable  absence  of  winking 
of  the  lids.  Palpation  of  the  lids  will  at  once  reveal  their 
condition. 

Prognosis.— If  of  peripheral  origin  and  resulting  from  simple 
contusing  a  favorable  termination  may  be  looked  for.  How- 
ever, if  indications  point  to  central  origin  the  condition  is 
often  permanent.  The  degree  of  injury  to  the  nerve  will 


TR1CHIASIS  503 

determine  the  prognosis.  Unfortunately  in  many  cases  this 
cannot  be  accurately  determined. 

Treatment.— As  the  eye  cannot  be  completely  closed,  the 
cornea  is  exposed  and  may  become  dry  and  injured.  An 
attempt  should  be  made  to  correct  this  if  possible.  Oily 
collyria  should  be  instilled  in  the  eye  two  or  three  times  daily. 
Massage  over  the  course  of  the  nerve  trunk  with  a  stimulat- 
ing liniment  (white  liniment,  soap  liniment)  often  produces 
good  results.  Internal  administration  of  strychnin  sulphate 
(0.001-0.0025  once  daily)  should  be  continued  for  a  few 
days.  If  no  results  are  obtained  from  the  treatment  after  a 
course  of  two  to  three  weeks  further  medication  should  be 
discontinued. 

Spasm  of  the  Orbicularis  Nerve. — Blepharospasm.— 
Definition.— A  tonic  or  clonic  spasm  of  the  eyelids.  It  may 
occur  periodically  or  be  continuous.  In  the  tonic  form  the 
eye  is  more  or  less  permanently  closed  and  -constitutes 
usually  a  reflex  symptom  of  a  local  eye  disease,  such  as  kera- 
titis,  panophthalmitis,  conjunctivitis,  or  the  presence  of 
foreign  bodies  in  the  eye.  Naturally  the  vision  is  interfered 
with  by  the  original  affection  as  well  as  by  the  spasm  of  the 
orbicularis  nerve. 

Clonic  blepharospasm  is  observed  in  dogs  following  dis- 
temper when  chorea-like  movements  are  a  sequel.  Rapid 
contractions  and  relaxations  of  the  lid  (winking)  take  place. 
Twitching  of  the  muscles  of  the  face  and  ear  often  are  asso- 
ciated with  the  eye  symptoms. 

Treatment.— An  examination  of  the  eye  should  always  be 
made  to  determine  the  cause  of  the  condition.  If  the  symp- 
toms result  from  local  affections,  treatment  must  be  applied 
to  relieve  the  special  condition.  If  no  local  involvement  can 
lie  found,  treatment  is  out  of  the  question.  Twitching  of 
the  eyelid  as  a  sequel  to  distemper  may  disappear  in  a  few 
weeks,  or  may  remain  permanently.  Treatment  has  been 
unsatisfactory. 

TRICHIASIS. 

Definition.— An  abnormal  position  or  direction  of  the  eye- 
lashes. The  condition,  as  a  rule,  is  not  observed  in  animals 


504  DISEASES  OF  THE  EYELIDS 

unless  the  lashes  are  directed  toward  the  cornea  and  more  or 
less  injury  to  this  membrane  occurs.  Trichiasis  is  often  con- 
genital in  dogs,  although  it  may  be  acquired.  The  smaller 
breeds  of  dogs  are  most  often  affected  (Pekinese  and  Japanese 
spaniels).  It  also  occurs  in  the  cat  and  bird.  In  the  latter 
fine,  small  feathers,  which  take  the  place  of  the  eyelashes, 
are  misdirected. 

Symptoms.— The  principal  symptoms  are  lacrimation,  kera- 
titis,  blepharo spasm,  and  ulceration  of  the  cornea.  The  eye 
must  be  examined  by  elevating  the  lids,  and  after  cleansing 
with  tepid  water  the  lashes  will  be  seen  taking  an  abnormal 
direction.  Extensive  irritation  and  injury  have  been  observed 
in  such  cases  when  they  have  been  neglected. 

Prognosis.— Favorable,  except  when  the  complications  lead 
to  corneal  ulcer,  or  panophthalmitis. 

Treatment.— Removal  of  the  offending  lashes  is  the  first 
consideration.  Their  removal  is  effected  by  pulling  them 
out  with  small  tweezers  or  forceps.  Temporary  relief  can 
also  be  obtained  by  cutting  the  lashes  close  to  the  margin 
of  the  lids.  More  permanent  results  will  be  obtained  by 
performing  the  entropion  operation.  Any  injury  to  the 
structures  of  the  eye  should  be  treated  with  antiseptics 
(boric  acid  2  per  cent,  solution  in  distilled  water). 

DISTRICfflASIS. 

Definition.— A  condition  in  which  there  are  two  rows  of 
eyelashes  present  on  the  margin  of  the  lids.  One  row  is 
usually  normally  directed  while  the  other  is  misdirected 
against  the  eyeball.  The  smaller  breeds  of  dogs  are  most 
often  affected.  The  abnormal  lashes  grow  out  from  the 
puncta  or  outlets  of  the  Meibomian  glands. 

The  symptoms  and  treatment  are  the  same  as  in  trichiasis. 

ADHESIONS  OF  THE  EYELIDS. 

A  normal  adhesion  of  the  eyelids  is  found  at  birth,  and 
continues  for  a  period  of  twelve  to  fifteen  days.  At  this 
period  the  eyelids  open  and  assume  their  normal  function 


ADHESIONS  OF  THE  EYELIDS  505 

unless  some  abnormality  is  present.  Adhesions  form  between 
the  margins  of  the  lids  which  may  be  partial  or  complete 
(ankyloblepharon),  or  betwreen  the  eyelids  and  the  eyeball, 
the  margins  of  the  lids  being  free  (symblepharon). 

Ankyloblepharon.— In  complete  ankyloblepharon  the  pal- 
pebral  fissure  has  entirely  disappeared.  An  incomplete 
closure  of  the  palpebral  fissure  is  known  as  blepharophimosis. 
This  condition>  as  a  rule,  is  congenital,  and  is  found  in  the 
dog  and  cat.  It  is  diagnosed  readily.  A  sufficient  time  should 
be  allowed  (ten  to  eighteen  days)  for  the  normal  adhesions 
to  disappear.  Very  often  there  will  be  found  a  small  line  or 
groove  at  the  point  where  the  opening  should  be. 

Treatment.— A  small  opening  is  made  through  the  lid  at 
the  outer  canthus,  a  grooved  director  inserted  and  the  incision 
carried  clear  across  to  the  inner  canthus.  The  after-treatment 
consists  in  washing  the  eyes  with  a  boric  acid  solution  (2  per 
cent),  and  applying  vaseline  to  the  lid  margins  to  prevent 
further  adhesions. 

In  blepharophimosis  there  is  a  narrowing  of  the  palpebral 
fissure  which  makes  the  eye  appear  much  smaller  than  normal. 
It  is  often  associated  with  trichiasis  or  entropion.  To  correct 
it  the  palpebral  opening  should  be  enlarged  at  the  external 
canthus,  and  the  skin  sutured  back  both  on  the  upper  and 
lower  lids  to  prevent  adhesions.  This  operation  will  also 
correct  trichiasis  or  entropion  if  either  should  be  present. 
Keep  the  wound  clean  and  apply  a  mild  ointment  to  the 
recently  incised  margins. 

Symblepharon.— This  is  an  adhesion  of  the  eyelids  to  the 
eyeball,  and  has  been  observed  in  dogs  and  cats.  The 
majority  of  cases  are  congenital.  Occasionally  an  acquired 
symblepharon  is  found  due  to  adhesions  following  destruction 
of  the  conjunctiva!  membrane  during  the  course  of  distemper. 
An  examination  of  the  eye  will  at  once  reveal  the  condition. 
The  lids  cannot  be  everted  and  are  found  adherent  to  the 
eyeball. 

Treatment.— Separation  of  the  lid  from  the  eyeball  is  pos- 
sible. The  animal  should  be  anesthetized.  The  lids  are 
carefully  separated  so  that  the  eyeball  is  left  intact.  The 
operation  can  be  done  satisfactorily  with  a  fine  pair  of 


506  DISEASES  OF   THE  EYELIDS 

scissors  or  a  very  small  scalpel.  After  the  operation  is  com- 
pleted all  hemorrhage  must  be  controlled  and  an  antiseptic 
ointment  applied  under  the  lids.  Yellow  oxid  of  mercury 
ointment  has  proved  satisfactory  for  this  purpose.  It  should 
be  applied  daily. 

LAGOPHTHALMUS. 

Definition. — An  incomplete  closure  of  the  eyelids  in  which 
a  portion  of  the  cornea  is  left  exposed.  When  the  cornea  or 
conjunctiva  is  left  continuously  exposed  to  the  air  without 
the  normal  secretions  covering  them,  they  become  irritated, 
inflamed  and  serious  alterations  take  place.  The  membranes 
are  thickened,  the  cornea  opaque  and  dry,  and  may  even 
become  perforated.  The  tears  follow  the  angle  of  the  eyelids 
and  flow  down  over  the  face.  The  condition  is  brought  about 
in  most  cases  by  ectropion,  exophthalmos,  enlargement  of  the 
eyeball,  and  some  few  cases  by  paralysis  of  the  orbicularis 
nerve.  Wounds  of  the  lids  with  extensive  loss  of  substance 
may  also  produce  it. 

Treatment.— The  first  indication  is  to  remove  the  cause, 
if  possible.  If  this  cannot  be  done  the  only  thing  left  is- to 
protect  the  conjunctiva  and  cornea  from  dessication  and 
eventual  destruction.  Oily  solutions  are  best  for  this  purpose. 
Instill  them  into  the  eye  once  or  twice  daily. 

TUMORS  OF  THE  EYELIDS. 

Several  varieties  of  tumors  are  found  on  the  eyelids  of 
small  animals. 

Papillomata. — Warts.—  These  are  not  uncommon  in  dogs 
and  birds.  The  wart-like  excrescences  found  in  birds,  par- 
ticularly parrots,  are  usually  tubercular,  and  are  often  asso- 
ciated with  degenerations  and  abscess  formation.  In  old 
dogs  and  cats,  horn-like  growths  are  found  as  outgrowths 
from  the  walls  of  Meibomian  cysts.  Small  warts  are  also 
seen  developing  along  the  margin  of  the  lid,  or  on  the  skin 
over  the  eyelid.  During  the  course  of  epitheliosis  of  birds 
small  horn-like  growths  appear  on  the  lids. 

Treatment.— Small  warts  appearing  on  the  margin  of  the 
lids,  or  skin,  are  removed  with  the  scissors.  Cauterize  the 


TUMORS  OF  THE  EYELIDS  507 

base  of  them  with  silver  nitrate,  and  follow  at  once  with  salt 
solution  to  prevent  undue  caustic  action  and  injury  to  the 
eye.  Tubercular  nodules  and  warts  in  parrots  should  be 
incised  and  removed  as  completely  as  possible.  Conserve 
as  much  of  the  eyelid  as  possible.  In  epitheliosis  the  warts 
should  be  removed  with  the  knife  or  curette  and  iodin  applied. 
Warts  projecting  out  from  the  Meibomian  glands  are  opened 
and  curetted  with  a  small  instrument.  The  base  of  the  warts 
should  be  carefully  cauterized. 

Chalazion. — Meibomian  Cyst.— These  are  small  cystic 
growths,  appearing  on  the  free  margin  of  the  lid,  or  on  the 
skin,  standing  out  prominently.  They  are  sebaceous  cysts 
having  no  inflammatory  reaction  and  filled,  as  a  rule,  with  a 
thick  honey-like  material.  A  true  chalazion  is  a  retention 
of  the  secretions  of  the  Meibomian  glands.  They  are  fre- 
quently observed  in  dogs,  more  commonly  in  mature  animals. 
They  form  a  firm,  circumscribed  swelling,  gradually  enlarg- 
ing until  they  reach  the  size  of  a  pea  or  walnut.  A  differentia- 
tion is  difficult  to  make  as  they  resemble  sebaceous  cysts. 
Their  development  often  leads  to  a  horny-like  excrescence 
on  the  surface,  and  often  take  on  the  character  of  a  malignant 
growth.  They  may  involve  the  free  margin  of  the  lid,  or 
extend  to  the  entire  structure  of  the  upper  eyelid. 

Treatment.— Small  sebaceous  cysts  are  opened  and  the 
contents  squeezed  out.  The  opening  is  made  large  enough 
in  order  that  the  gland  can  be  destroyed  with  iodin  or  silver 
nitrate. 

In  true  chalazion  it  is  advisable  to  remove  a  small  trian- 
gular portion  of  the  lid,  including  the  cyst,  with  the  base  of 
the  triangle  on  the  margin  of  the  lid.  This  is  best  done,  under 
morphin  anesthesia,  with  the  scissors.  Approximate  the 
wound  thus  made  with  fine  silk  or  linen.  Union  is  usually 
complete  in  ten  days  to  two  weeks.  Curetting  the  enlarge- 
ment may  be  tried  in  cases  where  the  operation  is  not  possible. 

Pilosebaceous  Cysts. — These  are  found  on  the  upper  eye- 
lid in  dogs,  especially  bulldogs  and  pugs  with  wrinkled  skin. 
The  contents  of  the  cysts  are  hair,  sebum,  and  pus,  which 
is  usually  discharged  through  a  fistulous  opening. 


508  DISEASES  OF   THE  EYELIDS 

Treatment.— The  cyst  should  be  opened,  curetted,  and  the 
cyst  wall  destroyed  with  tincture  of  iodin. 

Lipoma  and  Sebaceous  Tumors  in  Birds.— These  are  fre- 
quently observed  in  the  different  species  of  birds.  The 
tumors  are  well  defined,  of  a  firm  consistency,  and  vary  in 
size  from  a  pea  to  a  walnut.  On  opening  the  tumor  fatty 
tissue  may  be  seen,  or  which  is  more  common,  a  yellowish, 
cheesy,  tough  material  enclosed  in  a  distinct  capsule  is  present. 
They  are  situated  immediately  under  the  skin.  From  their 
nature  they  are  either  lipomas  or  sebaceous  cysts.  Various 
conditions  are  found.  Sometimes  the  cysts  will  rupture, 
discharging  the  material,  while  in  other  cases  horny  growths 
will  partially  replace  the  cyst.  Very  often  a  number  of  birds 
in  a  flock  will  be  affected. 

Treatment.— Incise  the  tumor,  remove  all  the  contents  and 
apply  tincture  of  iodin  to  its  base.  Free  hemorrhage  may 
occur  after  incision,  which  can  be  controlled  by  cauterizing 
with  silver  nitrate. 

Enlargement  of  the  Glands  of  Moll.— These  small  glands 
are  situated  along  the  free  margin  of  the  eyelid,  their  ducts 
emptying  into  the  glands  of  the  hair  follicles.  They  are 
enlarged  commonly  in  older  animals.  The  cysts  are  clear, 
transparent,  and  varying  in  size  from  a  wheat  grain  and 
smaller. 

Treatment.— The  contents  of  the  cysts  are  discharged. 
This  is  best  done  by  crushing  the  small  cyst  with  an  artery 
forceps.  Iodin  is  then  applied  to  destroy  the  gland  and  cyst 
wall. 

Granulomas. — Resulting  from  wounds,  granulomatous 
tissue  is  often  found  developing  on  the  free  margin  of  the 
lids,  or  on  the  surface.  This  is  easily  determined  by  its 
general  appearance.  If  there  should  be  doubt  a  definite 
diagnosis  may  be  made  with  the  microscope. 

Treatment.— Complete  extirpation  is  indicated.  Cauterize 
the  base  of  the  tumefaction  with  silver  nitrate,  or  actual 
cautery. 

Malignant  Neoplasms.— Several  varieties  of  malignant 
tumors  have  been  found  involving  the  eyelids  of  small  animals. 


TUMORS  OF  THE  EYELIDS  509 

Epitheliomata,  sarcomata,  carcinomata,  and  tuberculomata 
are  the  ones  most  often  observed. 

Diagnosis.— A  diagnosis  is  made  partly  on  the  character 
of  the  growth  and  finally  by  microscopic  examination. 

Treatment.— Complete  excision  of  the  tumor  should  be 
attempted  as  early  as  possible.  When  the  entire  eyelid  is 
involved  treatment  is  of  very  little  value.  A  recurrence  of 
the  tumors  is  liable  to  occur  after  operation.  In  removing 
the  tumor  as  much  as  possible  of  the  eyelid  should  be  saved. 


CHAPTER  II. 
DISEASES  OF  THE  CONJUNCTIVA. 

Examination.— Examination  is  simple  in  the  dog,  cat  and 
bird.  The  animal  should  be  held  either  by  an  assistant  or 
restrained  so  as  to  facilitate  the  examination.  Ordinary 
daylight  or  artificial  light  may  be  used.  The  lower  lid  can 
be  pulled  downward  by  placing  the  thumb  on  or  near  the 
palpebral  margin,  and  the  upper  lid  pushed  upward  with 
the  index  finger  of  the  same  hand  in  a  similar  position.  This 
manipulation  will  expose  nearly  all  of  the  membrane.  The 
examination  is  made  for  inflammations,  foreign  bodies,  cysts, 
tumors,  and  wounds  of  various  kinds.  Vicious  animals 
should  be  restrained  by  taping  the  mouth  or  by  general 
anesthesia. 

CONJUNCTIVITIS. 

Definition.— Inflammation  of  the  conjunctiva.  In  small 
animals  various  types  of  inflammation  are  of  frequent  occur- 
rence. These  animals  are  subjected  to  injuries  which  often 
involve  the  conjunctival  membrane,  and  infectious  diseases 
(distemper  in  dog  and  cat,  epitheliosis  in  bird)  which 
produce  various  .  forms  of  inflammation.  The  xerosis 
bacillus,  Staphylococcus  albus  and  S.  aureus,  strepto- 
coccus, diphtheria  bacillus  and  others  are  more  or  less  present 
in  the  eye  leading  in  many  cases  to  local  infection  and 
inflammation. 

It  is  noted  further  that  the  conjunctival  membrane  is 
very  vascular,  rich  in  lymph  cells,  and  sensitive  to  outside 
influences,  all  of  which  tend  to  favor  the  development  of 
inflammatory  conditions. 

The  following  forms  of  conjunctivitis  are  recognized: 

(a)  Catarrhal,  (b)  purulent,  (c)  parenchymatous,  (d) 
croupous,  (e)  follicular,  and  (/)  exanthematous. 


CONJUNCTIVITIS  511 

Catarrhal  Conjunctivitis.— A  form  of  inflammation  of  very 
frequent  occurrence  in  all  small  animals.  It  is  characterized 
by  congestion,  swelling,  and  a  discharge  which  may  be  serous, 
mucous,  or  mucopurulent. 

Etiology.— Catarrhal  conjunctivitis  is  often  associated  with 
or  secondary  to  other  diseases,  such  as  eczema,  distemper, 
epitheliosis,  nasal  catarrh,  bronchitis  and  some  constitutional 
diseases. 

Mechanical  conjunctivitis  often  occurs  in  small  animals 
from  injuries  of  various  kinds,  foreign  bodies,  dirt  or  dust 
getting  into  contact  with  the  membranes.  Cold  winds  some- 
times produce  it  in  hunting  dogs. 

Irritating  collyria  instilled  too  often  may  produce  it.  Seri- 
ous disturbances  are  frequently  observed  from  too  strong 
solutions. 

Infection  no  doubt  plays  an  important  role  in  producing 
catarrhal  conjunctivitis.  The  ordinary  infection  is  con- 
stantly present  and  develops  when  the  local  resistance  is 
reduced. 

Symptoms. — There  is  a  distinct  change  in  the  color  of  the 
membrane  and  a  mucous  or  mucopurulent  discharge.  The 
congestion  of  the  membrane  produces  a  pink  or  reddish 
coloration  which  may  be  accompanied  by  a  slight  yellow  tinge 
due  to  interstitial  infiltration. 

The  secretion,  at  first  serous,  soon,  changes  to  mucous  or 
mucopurulent  and  collects  around  the  palpebral  margin. 
The  edges  of  the  lids  are  found  edematous. 

Some  photophobia  is  present.  The  animal  will  show  more 
or  less  constant  movement  of  the  lids,  and  holds  the  lids  par- 
tially or  completely  closed.  A  careful  examination  reveals 
the  true  nature  of  the  condition. 

Prognosis.-— As  a  rule  favorable  except  when  secondary  to 
infectious  diseases.  The  inflammation  usually  subsides  in  a 
week  or  ten  days. 

Treatment.— A  careful  examination  should  be  made  to 
determine  whether  any  foreign  substances  are  present  which 
must  be  carefully  removed. 

Wash  the  membranes  thoroughly  with  boric  acid  (2  per 
cent.).  This  can  be  repeated  two  or  three  times  daily  during 


512  DISEASES  OF  THE  CONJUNCTIVA 

the  first  few  days.  Follow  each  application  of  boric  acid 
with  an  instillation  of  one  of  the  following  solutions:  Zinc 
sulphate  (1-1|  per  cent.) ;  tannic  acid  (1-2  per  cent.) ;  chinosol 
(1-500);  protargol  (2-4  per  cent.);  or  if  the  condition  is 
persistent  solution  of  silver  nitrate  (0.5  per  cent.). 

The  animal  should  be  isolated  and  the  premises  disinfected 
to  avoid  spreading  the  disease. 

Purulent  Conjunctivitis . — Blennorrhea. —Acute  Form.  — 
Definition. — A  purulent  secretion  present  in  one  or  both  eyes. 
In  this  condition  the  discharge  is  more  copious  and  the 
inflammation  more  intense  than  in  catarrhal  conjunctivitis. 
Purulent  conjunctivitis  results  very  frequently  from  or 
accompanies  distemper  of  dogs  and  cats,  and  epitheliosis  in 
fowls.  It  often  occurs  as  an  epizootic  or  enzootic  in  kittens 
and  puppies.  Both  the  acute  and  chronic  forms  of  the 
disease  are  frequently  met  with  in  practice. 

Etiology.— The  majority  of  cases  can  be  determined  quite 
definite!}-  to  be  due  to  infection  accompanying  or  following 
infectious  diseases.  It  is  very  common  in  dog  distemper, 
cat  distemper,  and  epitheliosis  in  birds.  Various  kinds  of 
organisms  have  been  isolated  from  the  discharge  but  none 
of  them  has  been  proved  to  be  the  specific  cause.  The 
fact  that  large  numbers  of  puppies,  kittens  or  fowls  are 
affected,  when  closely  associated,  indicates  the  communicable 
character  of  the  disease.  It  is  possible  to  have  this  form  of 
conjunctivitis  follow  the  catarrhal,  owing  to  the  reduced 
resistance  of  the  membrane  which  allows  secondary  infection 
to  develop.  It  is,  however,  possible  that  many  cases  are 
produced  in  fowls  and  in  some  of  the  other  animals  by  a 
parasite.  Several  species  of  parasites  have  been  isolated 
from  the  conjunctival  sac  of  birds. 

Newly  born  animals  contract  the  disease  from  the  vaginal 
infection  of  the  mother  at  the  time  of  parturition. 

Symptoms.— The  conjunctival  membrane  is  of  an  intense 
red  color  and  more  or  less  uniform  over  its  entire  surface. 
The  degree  of  redness  depends  upon  the  severity  of  the 
infection  and  the  stage  of  development.  In  many  cases  the 
mucous  membrane  is  prominent  from  the  edematous  swelling 
resulting  from  the  irritation,  thus  giving  it  a  "pouching  out" 


CONJUNCTIVITIS  513 

appearance.  The  amount  of  pus  present  is  more  or  less 
characteristic.  The  eye  is  often  entirely  filled  with  a  thick, 
whitish,  glutinous  pus,  which  becomes  dried  around  the 
palpebral  borders  and  forms  crusts  frequently  agglutinating 
the  eyelids.  On  account  of  the  spread  of  the  infection  to  the 
cornea,  this  organ  becomes  cloudy  or  even  ulcerated.  Owing 
to  the  irritant  action  of  the  pus  the  animal  will  show  con- 
siderable pain,  scratch  and  rub  the  eyes  either  with  the  paws 
or  against  objects.  The  membrana  nictitans  is  red  and 
protrudes  over  a  portion  of  the  eyeball.  Most  cases  show 
considerable  photophobia. 

General.— General  symptoms  are  noted  in  many  cases  in 
the  form  of  dulness,  loss  of  appetite  and  general  weakness. 
There  may  be  sufficient  infection  to  produce  general  intoxica- 
tion and  death  in  birds.  In  these  cases,  however,  it  is  quite 
likely  that  the  infection  is  found  in  other  parts  of  the  body. 

Prognosis.— The  prognosis  is  not  always  favorable.  Due 
to  complications,  which  may  involve  the  eyeball,  partial  or 
total  blindness  can  result.  While  many  cases  terminate  in 
complete  resolution,  others  produce  ulcerations  and  perfora- 
tions of  the  cornea.  When  the  latter  occurs  panophthalmitis 
is  the  result.  In  some  animals,  particularly  birds,  this  would 
seriously  interfere  with  the  obtaining  of  food.  When  para- 
sites are  the  cause  of  the  condition  other  complications 
follow,  such  as  infestation  of  the  nasal  passages  and  sinuses, 
and  in  some  cases  invasion  of  the  air  sacs. 

Treatment. — Thorough  disinfection  of  the  premises,  houses, 
etc.,  should  be  practised  in  order  to  prevent  the  spread  of  the 
infection.  This  can  be  accomplished  either  by  the  use  of 
liquor  cresolis  compositus  (3  per  cent.)  with  which  all  places 
and  articles  in  contact  with  the  animals  are  thoroughly 
saturated,  or  the  animals  are  removed  from  the  house  or 
kennel  which  is  then  disinfected  with  formaldehyd  fumes. 

The  general  condition  of  the  patient  must  be  considered 
and  its  strength  maintained  by  good,  nourishing  food  and 
such  tonics  as  tincture  of  gentian,  or  tincture  of  mix  vomica 
(0.2-0.4  twice  daily).  A  solution  of  iron  sulphate  (2  per 
cent.)  in  the  drinking  water  has  proved  of  value  as  a  tonic 
for  birds. 
33 


514  DISEASES  OF  THE  CONJUNCTIVA 

Local  treatment  is  applied  at  least  twice  daily  in  order  to 
remove  the  irritating  material  from  the  conjunctival  sac, 
and  also  to  destroy  infection.  Many  preparations  have  been 
recommended  and  used  for  this  purpose:  Boric  acid  (2  per 
cent.);  creolin  (2  per  cent.);  chinosol  (1-500);  protargol 
(2-3  per  cent.) ;  or  in  severe  cases  silver  nitrate  (0.5  per  cent.). 
This  treatment  must  be  continued  for  one  to  two  weeks  to 
obtain  the  best  results. 

Chronic  Form.— This  form  of  the  disease  has  been  observed 
very  frequently  in  dogs  and  cats  following  infectious  and 
contagious  diseases.  To  recognize  it  as  being  separate  from 
the  acute  form  is  necessary  on  account  of  its  persistent  and 
long  course.  It  is  very  common  in  old  animals  and  those 
kept  under  bad  hygienic  conditions.  Many  cases  of  eczema 
and  mange  are  associated  with  chronic  purulent  conjuncti- 
vitis. It  may  follow  the  acute  form. 

Symptoms.— The  condition  of  the  conjunctiva  and  the 
presence  of  pus  with  agglutination  of  the  palpebral  margins 
present  the  appearance  in  general  of  the  acute  form.  On 
examination  the  conjunctiva  is  found  to  be  dull  red  in  color, 
slightly  edematous  and  the  cornea  frequently  has  numerous 
small  bloodvessels  over  its  surface.  The  general  condition 
of  the  patient  is  usually  bad. 

Prognosis.— Owing  to  the  chronic  nature  of  the  disease  and 
its  persistency  the  prognosis  is  not  favorable.  The  disease 
may  last  for  months  or  even  the  entire  life  of  the  animal. 

Treatment.— One  of  the  first  essentials  in  the  treatment 
of  this  disease  is  to  secure  good  sanitary  conditions,  giv- 
ing plenty  of  nourishing  food  and  do  everything  possible 
to  increase  the  strength  of  the  patient.  The  various  anti- 
septic solutions  recommended  for  the  acute  form  may  also 
be  tried. 

Good  results  have  followed  in  some  chronic  cases  by  pre- 
paring an  autogenic  vaccine  and  administering  1  to  2  c.c. 
subcutaneously  every  three  to  five  days.  This  in  con- 
junction with  the  above  treatment  has  proved  to  be  of 
considerable  value. 

Parenchymatous  Conjunctivitis. — Erysipelatons  Conjuncti- 
vitis.— Definition.—  An  inflammation  of  the  deeper  layers  of 


CONJUNCTIVITIS  515 

the  conjunctiva  and  its  submucous  tissue.  It  occurs  in  all 
small  animals,  most  frequently  in  birds. 

Etiology.— There  are  many  factors  producing  parenchy- 
matous  conjunctivitis.  Many  of  them  are  the  same  as  those 
causing  the  catarrhal  form.  Injuries  to  the  mucous  mem- 
branes and  underlying  structures  can  produce  it.  Chronic 
agents  in  the  form  of  irritants,  such  as  irritating  collyria, 
when  used  too  often  or  in  too  large  quantities;  thermic  agents 
in  the  form  of  hot  water  or  hot  antiseptic  solutions.  The 
disease  is  observed  in  hunting  dogs  from  exposure,  or  to 
foreign  bodies  getting  into  the  eyes  while  going  through 
briers  and  brush.  Infection  plays  an  important  role  in  the 
production  of  this  form  of  conjunctivitis.  The  infection  is 
often  introduced  directly  into  the  conjunctiva!  sac  where  it 
enters  small  wounds  and  produces  intense  inflammation  of 
the  parenchyma.  Numerous  organisms  have  been  isolated 
in  these  cases.  It  is  evident  that  no  one  specific  organism 
produces  it.  The  disease  may  also  develop  secondarily 
(hematogenously)  to  some  of  the  infectious  diseases.  It  is  a 
common  sequel  to  dog  distemper  or  epitheliosis  of  fowls. 

Symptoms.  -The  early  indications  of  the  disease  are 
swelling  and  puffiness  of  the  mucous  membrane.  This  is  so 
marked  in  many  cases  that  the  swollen  conjunctiva  pouches 
outward  over  the  palpebral  borders  or  the  cornea.  During 
this  stage  the  conjunctiva  is  intensely  congested  and 
reddened.  There  is  considerable  lacrimation  and  photo- 
phobia during  the  entire  period  of  the  disease.  In  the  second 
stage  there  is  a  purulent  discharge  from  the  eye,  which  may 
be  very  copious.  The  general  condition  of  the  patient  is 
usually  not  disturbed  unless  complications  develop,  or  from 
the  attending  infectious  diseases. 

Prognosis.  The  prognosis  in  most  primary  cases  is  favor- 
able. In  the  acute  form  it  subsides  in  a  week  or  ten  days. 
When  secondary  to  infectious  diseases,  the  prognosis  is  not 
so  favorable.  In  such  instances  it  may  develop  into  a  chronic 
purulent  conjunctivitis. 

Treatment.  -  -Prompt  treatment  is  important  in  preventing 
the  spread  of  the  inflammation.  Antiseptic  and  astringent 
solutions  should  be  employed:  Boric  acid  (2  per  cent.); 


516  DISEASES  OF  THE  CONJUNCTIVA 

lead  water  (2  per  cent.);  potassium  permanganate  (£  per 
cent.);  tincture  opium  (1  per  cent.).  If  the  patient  shows 
considerable  pain  and  irritation  with  marked  congestion  of 
the  membrane,  codrenin  solution  (2  per  cent.),  or  a  few  drops 
of  stovain  solution  (2  per  cent.)  are  recommended.  When 
intense  pain  is  present  and  the  conjunctiva  is  a  dull,  red  color 
indicating  a  subacute  inflammation,  silver  nitrate  (0.5  per 
cent.)  is  of  value. 

Croupous  Conjunctivitis.— Definition.— An  inflammation  of 
the  conjunctiva  characterized  by  the  formation  of  a  pseudo- 
membrane  which  covers  its  surface.  Croupous  conjunctivitis 
is  observed  more  commonly  in  the  dog  and  cat.  In  birds  it 
accompanies  epitheliosis,  when  the  eyes  are  involved. 

Etiology.— The  majority  of  cases  occurring  in  the  dog  and 
cat  are  produced  either  by  chemical  irritation  or  as  a  result 
of  specific  infection  following  or  accompanying  infectious 
diseases.  In  birds,  owing  to  the  prevalency  of  epitheliosis, 
large  numbers  in  an  individual  flock  may  be  affected  at  the 
same  time. 

Symptoms.— The  conjunctiva  is  covered  with  a  fibrinous 
exudate  which  frequently  extends  over  the  cornea.  The 
corneal  surface  may  be  entirely  covered.  In  birds  a  very 
heavy,  thick,  fibrinous  membrane  completely  covers  the 
entire  anterior  surface  of  the  eye.  Due  to  exudate  and 
secretions  collecting  under  the  pseudomembrane,  it  is  forced 
outwardly  protruding  between  the  lids.  If  the  membrane 
is  removed,  the  eye  will  be  found  normal  in  position  and  color. 
There  are  no  general  symptoms  except  as  produced  by  some 
infectious  diseases  which  the  conjunctivitis  attends. 

Prognosis.— Favorable  in  primary  cases.  When  secondary 
the  prognosis  depends  upon  the  primary  disease  it  accom- 
panies. 

Treatment.— The  animal's  general  condition  should  be 
observed  and  any  necessary  treatment  applied.  The  eye 
may  be  flushed  out  with  a  warm  boric  acid  solution  and  the 
croupous  membrane  removed  with  a  pledget  of  cotton  or  a 
pincette.  After  the  membrane  is  removed,  apply  antiseptic 
or  astringent  collyria.  It  will  probably  be  necessary  to  re- 
move fragments  of  membrane  as  they  later  develop. 


CONJUNCTIVITIS  517 

Follicular  Conjunctivitis.— Definition.— An  inflammation  of 
the  conjunctiva  characterized  by  the  formation  of  small, 
granular  elevations  over  its  surface.  These  granulations  are 
due  to  swelling  of  the  lymph  follicles  and  to  connective 
tissue  proliferation,  the  result  of  inflammation.  The  granu- 
lations often  attain  the  size  of  a  grain  of  millet  or  larger. 
Follicular  conjunctivitis  occurs  usually  on  the  inner  surfa'« 
of  the  membrana  nictitans.  In  a  large  number  of  dog^ 
examined,  nearly  one-half  were  found  to  be  affected  with , 
this  disease.  House  dogs  seem  more  susceptible  than  others. 

Etiology.— The  cause  is  unknown.  Many  etiological 
factors  have  been  accused,  such  as  dirt,  dust  and  other 
irritants  which  enter  the  eye.  Undoubtedly  many  cases 
result  from  distemper. 

Symptoms.— As  such  a  large  number  of  dogs  are  affected 
with  enlarged  lymph  follicles  on  the  membrana  nictitans  one 
is  led  to  conclude  that  their  presence  may  not  be  abnormal. 
However,  in  many  cases  the  granules  appear  also  over  the 
entire  conjunctiva  leading  often  to  ectropion,  an  outward 
rolling  of  the  eyelids.  On  examination  the  mucous  mem- 
brane will  be  found  to  be  of  a  dull  red  color  and  irregular  on 
the  surface.  Small,  white  granules  at  their  apices  stand  out 
quite  prominently  over  the  membrane.  The  membrana 
nictitans,  when  elevated  with  the  forceps,  will  disclose  small 
elevations  on  its  under  surface.  In  case  of  long  standing  the 
palpebral  margins  become  red  and  the  small  glands  prominent. 
There  is  some  lacrimation  and  frequently  a  discharge  of  pus 
from  the  inner  canthus.  During  the  later  stage  small  ulcers 
appear  on  the  apices  of  the  granulations,  which,  by  confluence, 
form  large,  ulcerated  surfaces.  The  eyes,  kept  partly  closed 
and  rubbed  with  the  pawrs,  show  evidence  of  irritation  and 
pain. 

Prognosis.— The  prognosis  is  not  very  favorable  because 
the  disease  is  usually  well  developed  before  the  animal  shows 
any  marked  symptoms.  Owing  to  the  chronic  character  of 
the  disease  the  course  is  protracted  requiring  long  continued 
treatment. 

Treatment.— A  thorough  examination  should  be  made  of 
the  entire  conjunctiva  in  order  to  determine  the  extent  of 


518  DISEASES  OF  THE  CONJUNCTIVA 

the  disease.  The  ordinary  collyria,  such  as  zinc  sulphate 
(1  per  cent.) ;  silver  nitrate  (0.5  per  cent.),  or  chinosol  (1-500), 
should  be  used  for  a  few  days  to  remove  all  of  the  surface 
infection  and  astringe  the  membrane.  Following  this  treat- 
ment the  affected  parts  of  the  conjunctiva  are  cauterized 
with  silver  nitrate.  Apply  immediately  a  solution  of  sodium 
cl^orid  to  prevent  injury  to  the  cornea.  This  operation 
c'£  ly  be  repeated  in  a  few  days,  if  necessary.  In  the  mean- 
\e  the  astringent  and  antiseptic  solutions  are  to  be  con- 
aed. 

It  is  advisable  to  remove  the  membrana  nictitans  when  it 
nows  the  pronounced  follicular  granulations.  This  is  best 
,ione  in  the  following  manner:  The  animal  may  be  given 
a  general  anesthetic,  or  anesthetize  the  membrane  locally 
by  instilling  0.8-1.5  of  codrenin  solution  in  the  affected 
eye.  If  the  latter  is  used  the  operation  should  be  delayed  for 
ten  or  fifteen  minutes  for  complete  anesthesia.  The  animal 
is  placed  on  the  operating  table,  held  by  an  assistant,  the 
membrana  nictitans  grasped  with  a  small  forceps  and  pulled 
outwardly  toward  the  inner  canthus  of  the  eye.  It  is  then 
cut  off  carefully  with  a  curved  scissors.  Care  must  be  taken 
to  prevent  removal  of  any  of  the  other  conjunctival  mem- 
brane, as  this  would  lead  to  scar  formation  and  result  in 
entropion.  Serious  hemorrhage  may  occur  in  individual 
cases.  If  the  hemorrhage  is  copious  a  gauze  pack  should  be 
placed  over  the  eye  and  held  in  place  by  a  head  bandage. 
This  may  be  removed  in  twenty-four  hours  and  the  ordinary 
antiseptic  solutions  used.  Recovery  from  the  operation 
requires  ten  days  to  two  weeks. 

Exanthematous  Conjunctivitis.— Definition.— An  exanthe- 
inatous  eruption  occurring  during  the  course  of  certain 
diseases.  In  small  animals  this  form  of  conjunctivitis  is  not 
very  common,  but  has  been  observed  accompanying  or 
following  distemper  in  the  dog  and  cat.  Parasitic  skin 
diseases  and  eczemas  often  extend  to  the  conjunctiva  from 
the  skin  around  the  palpebral  margins.  This  frequently 
results  in  suppurative  inflammation  of  the  glands  along  the 
margin  of  the  lids,  and  in  the  membrana  nictitans.  Many 
cases  of  favus  in  fowls  extend  to  the  conjunctiva. 


TRAUMATIC  LESIONS  OF  THE  CONJUNCTIVA    519 

Treatment. —The  treatment  of  exanthematous  conjuncti- 
vitis is  very  similar  to  that  of  the  catarrhal  form  and  its 
varieties.  The  original  disease  must  be  treated,  and  anti- 
septic and  astringent  solutions  applied  to  the  affected  con- 
junctiva. When  there  is  severe  lacrimation,  calomel  has 
proved  to  be  of  considerable  value. 

PTERYGIUM. 

Definition.— A  triangular  fold  of  the  conjunctiva  and  sub- 
conjunctival  tissue  extending  over  a  part  of  the  cornea.  It 
is  derived  from  the  bulbar  conjunctiva  and  narrows  to  a 
point  as  it  extends  over  the  corneal  membrane. 

Symptoms.— Pterygium  develops  gradually  and  does  not 
produce  any  marked  irritation  except  a  slight  catarrhal 
inflammation.  When  it  extends  over  on  the  cornea  it  may 
affect  vision. 

Diagnosis. —The  diagnosis  is  not  difficult.  The  triangular 
growth,  attached  more  or  less  firmly  to  the  cornea,  rich  in 
bloodvessels,  which  gives  it  a  pink  or  reddish  cast,  charac- 
terizes it. 

Prognosis.— Pterygium  is  not  very  serious  and  can  usually 
be  operated  successfully. 

Treatment.— It  is  advisable  to  treat  the  mucous  membrane 
for  a  few  days  previous  to  the  operation  with  antiseptic  and 
astringent  solutions.  A  local  anesthetic  should  be  adminis- 
tered, or  if  the  animal  is  nervous,  general  anesthesia  would 
be  preferable.  Dissect  off  the  triangular  fold  of  membrane 
from  the  cornea  and  remove  it  as  near  the  base  as  possible 
with  the  scissors.  It  is  further  recommended  that  the  base 
of  the  growth  be  dissected  out  completely  and  the  wound 
sutured.  The  after-treatment  consists  in  the  use  of  antiseptic 
arid  astringent  solutions.  Recovery  is  usually  prompt,  and, 
if  the  operation  has  been  thorough,  the  growth  does  not 
return. 

TRAUMATIC  LESIONS  OF  THE  CONJUNCTIVA. 

Foreign  Bodies  in  the  Conjunctiva.— Various  kinds  of  sub- 
stances are  found  in  the  conjunctival  sac  of  small  animals. 


520  DISEASES  OF  THE  CONJUNCTIVA 

Dirt,  straws,  briars,  wheat  seeds,  splinters  of  wood,  etc.,  have 
been  observed  quite  commonly.  This  is  particularly  true 
in  hunting  dogs,  and  animals  that  are  kept  in  dusty  and 
unsanitary  kennels.  In  birds,  parasites  have  been  found  in 
a  number  of  cases  (spiroptera) .  These  substances  are  fre- 
quently found  underneath  the  membrana  nictitans. 

Symptoms.— All  foreign  bodies  cause  more  or  less  intense 
reactive  symptoms,  such  as  lacrimation,  photophobia,  serous 
or  mucopurulent  discharge,  swelling  of  the  eyelids,  opaque- 
ness of  the  cornea,  etc.  The  severity  of  the  symptoms  will 
depend  somewhat  upon  the  character  of  the  foreign  body  and 
the  degree  of  irritation.  The  patient  usually  shows  con- 
siderable pain,  rubs  the  eyes  against  objects  or  with  the  paws, 
and  thus  intensifies  the  symptoms. 

A  sudden  development  of  the  symptoms  cited  should  lead 
one  to  suspect  a-  foreign  body  in  the  eye. 

Treatment.— Flush  out  the  conjunctival  sac  with  warm 
water  or  boric  acid  solution  (2  per  cent.).  Raise  the  mem- 
brana nictitans  and  evert  the  lids  so  that  a  close  inspection 
of  the  entire  conjunctival  sac  can  be  made.  In  the  majority 
of  cases  the  foreign  body  is  visible.  A  reading  glass  will 
facilitate  finding  small  foreign  bodies. 

After  the  foreign  body  is  located  it  is  advisable  to  remove 
it  either  by  flushing  the  surface  with  a  boric  acid  solution 
(2  per  cent.)  or  by  grasping  it  with  a  small  forceps,  or  wiping 
it  out  with  a  pledget  of  cotton.  Considerable  care  should  be 
exercised  to  see  that  all  of  the  foreign  material  is  removed. 
After  removal  flush  the  mucous  membrane  two  or  three  times 
daily  with  boric  acid  solution  (2  per  cent.). 

Wounds  on  the  Conjunctiva.— Very  often  the  conjunctiva 
is  injured  by  sticks,  pieces  of  straw,  briers,  etc.  In  the 
majority  of  cases  the  injury  is  slight  and  of  little  significance. 
In  a  few  cases,  where  the  lesion  is  extensive,  there  will  be 
symptoms  similar  to  those  caused  by  foreign  bodies  in  the 
conjunctival  sac.  A  differentiation  is  made  only  by  a  careful 
examination. 

Treatment.— The  lids  should  be  everted  and  the  part 
thoroughly  examined  to  determine  the  extent  of  the  injury. 


ULCE  RATION  OF  THE  CONJUNCTIVA  f>21 

If  any  shreds  of  membrane  are  present,  they  should  be 
removed  with  the  scissors.  Antiseptic  and  astringent  collyria 
are  used  until  the  symptoms  subside. 

CORROSIONS  AND  BURNS  OF  THE  CONJUNCTIVA. 

These  occur  rather  commonly  in  dogs  and  cats  the  result 
of  accident  or  intent.  They  may  also  be  due  to  the  use  of 
strong  collyria.  A  common  practice,  when  dogs  are  fighting, 
is  to  separate  them  by  throwing  ammonia,  pepper,  or  other 
irritant  substances  into  their  eyes.  This  often  results  in  a 
serious  inflammation  of  the  conjunctiva  and  cornea.  Thermic 
agents,  such  as  hot  water,  also  produce  extensive  injury. 

Treatment.— A  careful  history  of  the  case  should  be 
obtained  if  possible  in  order  to  determine  the  cause  of  the 
injury.  It  would  be  best  to  first  flush  out  the  eyes  with  a 
warm  boric  acid  solution  (2  per  cent.),  and  if  the  injury  is 
produced  by  strong  alkalies,  follow  with  some  soothing, 
lubricating  agent,  such  as  warm  milk,  or  a  dilute  glycerin 
solution.  Oleaginous  preparations  are  also  to  be  recom- 
mended. Ophthalmic  ointments  are  useful.  If  the  cauter- 
ization has  produced  an  opacity  of  the  cornea,  of  great  value 
is  a  solution  of  succus  cineraria  maritima  compositus  (50 
per  cent.)  used  daily. 

ULCERATION  OF  THE  CONJUNCTIVA. 

A  more  or  less  extensive  ulceration  of  the  conjunctiva! 
membrane  occurs  following  diseases  or  injuries.  It  has  been 
observed  following  burns  and  corrosions;  in  birds,  tuberculosis 
produces  it. 

Treatment.-  When  ulceration  of  the  conjunctiva  occurs, 
the  part  should  be  thoroughly  cleaned,  curetted,  and  the 
base  of  the  ulcer  cauterized  with  silver  nitrate  followed  by 
salt  solution.  This  treatment  may  be  repeated  in  a  few  days, 
if  necessary.  The  conjunctiva!  sac  should  be  washed  daily 
with  boric  acid  (2  per  cent.)  to  prevent  infection  and  injury 
to  other  parts  of  the  eye. 


522  DISEASES  OF  THE  CONJUNCTIVA 

TUMORS  AND  GROWTHS  ON  THE  CONJUNCTIVA. 

In  small  animals,  tumors  involving  the  conjunctiva  and 
the  membrana  nictitans  are  of  frequent  occurrence.  Several 
varieties  of  tumors  have  been  observed.  The  principal  ones 
are :  Epitheliomas,  sarcomas,  tubercular  nodules,  dermoids, 
adenomas  of  the  glands  of  Harder,  papillomas,  fibromas  and 
lipomas.  It  is  very  essential  that  a  differential  diagnosis 
be  made  in  order  to  distinguish  the  malignant  from  the  non- 
malignant  varieties.  Malignant  growths  will  not  only  invade 
the  conjunctiva  but  spread  rapidly  to  the  adjacent  tissue,  and 
eventually  cause  the  destruction  of  the  entire  eyeball. 

Treatment.— All  enlargements  along  the  margin  of  the  lids, 
on  the  conjunctiva  or  on  the  membrana  nictitans  should  be 
removed  completely  as  early  as  possible.  This  operation  is 
best  accomplished  under  general  anesthesia.  The  after- 
treatment  would  consist  in  cauterizing  the  wound  and  the 
application  of  the  ordinary  antiseptics. 

INFLAMMATION  OF  THE  MEMBRANA  NICTITANS. 

Examination. — An  examination  of  the  membrana  nictitans 
is  very  easily  accomplished  in  small  animals  by  ordinary 
daylight.  Proper  restraint  of  the  animal  is  necessary  for  a 
careful  and  thorough  inspection.  If  the  animal  is  of  a  nerv- 
ous temperament,  or  inclined  to  be  vicious,  a  general  anes- 
thetic should  be  administered,  or  the  patient  hoppled  and  a 
tape  applied  around  the  mouth.  The  lids  are  then  everted 
or  held  open  with  the  thumb  and  finger  while  with  the  other 
hand  the  membrana  nictitans  can  be  grasped  writh  a  forceps 
and  elevated  so  that  all  parts  of  it  can  be  examined.  Exami- 
nation should  be  made  for  inflammation,  granular  enlarge- 
ments, tumors,  and  injuries. 

As  the  mucous  membrane  of  the  membrana  nictitans  is 
exposed  to  the  same  causes  of  disease  as  the  rest  of  the 
conjunctiva,  it  frequently  shows  lesions. 

Symptoms.— Inflammation  of  the  membrana  nictitans  is 
characterized  by  a  red,  more  or  less  flat  enlargement  appear- 
ing at  the  inner  palpebral  fissure.  In  severe  cases  the 


TUMORS  OF   THE   MEMBRANA   NICTITANS        523 

membrane  stands  out  prominently  and  extends  over  a  portion 
of  the  cornea.  A  protrusion  of  the  membrana  nictitans  is 
observed  in  tetanus,  which  should  not  be  mistaken  for  an 
inflammatory  condition.  This  can  easily  be  distinguished 
by  other  symptoms  of  tetanus  appearing  in  other  parts  of  the 
body. 

Prognosis.— Favorable  in  most  cases.  It  may  terminate 
in  a  chronic  inflammation  in  which  case  the  membrana 
nictitans  will  remain  permanently  thickened. 

Treatment.— The  entire  membrane  should  be  inspected 
closely  for  foreign  bodies.  Flush  out  the  membrane  daily 
with  boric  acid  solution  (2  per  cent.). 

If  in  the  course  of  two  or  three  weeks  the  swelling  has  not 
subsided,  it  would  indicate  a  chronic  inflammation.  In  this 
case  the  removal  of  the  entire  membrane  is  recommended. 

WOUNDS  OF  THE  MEMBRANA  NICTITANS. 

In  small  animals  wounds  of  the  membrana  nictitans  are 
produced  by  the  same  causes  as  those  producing  traumatic 
conjunctivitis  elsewhere.  As  a  rule  they  are  of  little  impor- 
tance unless  very  extensive  or  followed  by  marked  granula- 
tion .  Antiseptic  and  astringent  solutions  usually  suffice  to  heal 
them.  If  extensive  granulation  occur,  it  may  be  necessary 
to  extirpate  the  entire  membrane. 

TUMORS  ON  THE  MEMBRANA  NICTITANS. 

Various  tumors  have  been  found  on  the  membrana  nicti- 
tans. It  is  advisable  in  all  cases  to  remove  the  membrane 
surgically. 


CHAPTER  III. 
DISEASES  OF  THE  LACRIMAL  APPARATUS. 

Examination.— This  apparatus  consists  of  the  lacrimal 
gland  and  the  lacrimal  passages.  In  small  animals  it  is 
somewhat  difficult  to  make  an  examination  of  the  entire 
apparatus.  The  lacrimal  gland  in  the  dog  is  flat,  light  pink 
in  color,  of  a  mixed  type  and  is  situated  in  the  periorbit 
directly  under  the  orbital  ligament.  In  the  cat  the  position 
is  very  similar.  In  birds  the  gland  is  a  small,  round,  reddish 
body  against  the  eyeball  near  the  outer  canthus  and  opens 
upon  the  wall  of  the  eyelid  through  a  small  slit. 

The  lacrimal  openings  (puncta  lacrimalia)  are  elliptical 
fissures  and  are  two  in  number  in  the  dog  and  one  in  the  bird. 
The  lacrimal  canal  extends  from  the  lacrimal  gland  to  an 
opening  in  the  lower  border  of  the  nasal  canal.  This  is  a 
whitish,  membranous  tube  to  conduct  the  excessive  secretion 
into  the  nasal  passages.  The  entire  lacrimal  apparatus  is  of 
lesser  importance  in  small  animals  than  in  horses. 

LACRIMATION. 

Epiphora. 

Definition.— A  term  applied  to  designate  a  flow  of  tears 
over  the  lid  margins.  It  is  not  of  common  occurrence  in 
small  animals,  except  in  certain  breeds  of  dogs. 

Etiology.— (a)  Very  often  due  to  ectropion  or  entropion, 
which  may  produce  a  deviation  of  the  puncta  lacrimalia, 
allowing  the  secretion  to  flow  out  over  the  margin  of  the  lids. 
(b)  Obstruction  of  the  lacrimal  duct  by  foreign  substances, 
mucus,  etc.  (c)  Constriction  and  obliteration  of  the  duct 
due  to  injuries,  etc.  (d)  Lacrimation  is  often  seen  as  a  result 
of  irritation  or  diseases  affecting  the  conjunctiva!  membranes. 
In  this  case  the  secretion  forms  so  rapidly  that  the  lacrimal 
duct  cannot  carry  it  away,  the  excess  flowing  over  the  lid 
margins,  (e)  Ordinary  lacrimation  may  be  produced  by 
exposure  to  irritating  gases,  smoke,  dust  or  cold  air. 


DACRYOCYSTITIS  525 

Symptoms.— A  copious  tear  flow  over  the  lid  margin.  An 
examination  of  the  surroundings  of  the  patient  should  be 
made,  and  also  a  close  inspection  of  the  conjunctiva  and 
lacrimal  apparatus,  to  determine  if  possible  the  cause  of  the 
condition.  In  certain  breeds  of  dogs  (spaniels,  poodles, 
Boston  terriers)  it  should  not  be  looked  upon  as  anything 
serious. 

Prognosis.— As  soon  as  the  causes  are  removed  most  cases 
recover  promptly.  In  case  the  lacrimal  passages  are 
obstructed,  the  prognosis  would  be  unfavorable. 

Treatment.  —  If  possible  remove  the  cause  of  the  condition. 
If  in  the  lacrimal  passages,  the}-  should  be  opened  by  injecting 
a  warm  solution  of  boric  acid  (2  per  cent.)  or  sodium  bicar- 
bonate (1  per  cent.)  with  a  fine  nozzled  syringe.  As  the  duct 
is  often  very  small  the  operation  is  not  always  successful. 

DACRYOCYSTITIS. 

Definition.  —  An  inflammation  of  the  lacrimal  sac.  It  is 
quite  common  in  dogs  and  cats. 

Symptoms.— The  first  symptom  is  a  swelling  or  bulging  in 
the  neighborhood  of  the  inner  canthus  of  the  eye.  When 
pressed  with  the  finger  the  contents  are  forced  out  through 
the  puncta  lacrimalia.  The  discharge  may  be  serous,  mucoid, 
or  purulent,  depending  upon  the  age  of  the  condition.  The 
case  often  develops  suddenly,  the  skin  over  the  swelling 
becoming  shiny  and  red.  It  often  perforates  and  through 
the  opening  blood-tinged  pus  is  discharged.  Later  the 
discharge  becomes  mucoid  or  serous.  A  lacrimal  fistula 
frequently  results  from  the  continuous  tear  flow  through  the 
abscess  opening.  Dacryocystitis  usually  becomes  chronic. 

Prognosis.— On  account  of  its  chronicity  and  the  develop- 
ment of  fistula  the  prognosis  is  not  very  favorable.  As  a 
rule  several  weeks  are  required  to  bring  about  complete 
recovery. 

Treatment.  — In  dacryocystitis,  lacrimal  catarrh  and  fistula 
thorough  irrigation  with  warm  antiseptic  solutions  is 
indicated.  Apply  with  a  syringe  with  a  fine  long  nozzle. 
If  the  fistula  persists,  open  the  canaliculus  and  lacrimal  sac 
by  slitting  and  treat  as  an  open  wound. 


CHAPTER   IV. 
DISEASES  OF  THE  CORNEA. 

Examination.— The  cornea  is  normally  transparent  forming 
the  anterior  covering  of  the  eyeball.  It  is  shaped  somewhat 
like  a  watch-crystal  and  in  the  dog,  cat  and  bird  spherical  in 
form.  The  surface  is  smooth  and  shiny.  In  examining  the 
cornea  employ  either  daylight  or  artificial  light.  The  animal 
may  be  restrained  writh  an  anesthetic  or  hoppled  and  tape 
applied  around  the  mouth.  By  everting  the  eyelids  with 
the  thumb  and  index  finger  the  entire  cornea  is  exposed.  Its 
form  should  be  noted,  its  curvature  and  its  transparency. 
The  curvature  of  the  cornea  of  one  eye  should  be  compared 
with  that  of  the  other.  Of  assistance  in  this  regard  is  a 
lighted  candle.  By  noting  the  size  of  the  flame  as  reflected 
by  the  cornea  of  each  eye,  comparisons  may  be  made.  If 
the  curvature  is  weak,  the  flame  appears  larger;  if  strong, 
smaller.  In  dogs  and  cats  physiological  variations  will  be 
noted  in  the  curvature  of  each  cornea  due  to  the  difference 
in  the  shape  and  size  of  the  eyes.  The  surface  of  the  cornea 
should  be  smooth  and  even.  To  determine  these  observe  it 
from  the  side,  best  using  reflected  light.  The  cornea  should 
be  tested  for  sensitiveness  by  gently  touching  it.  It  is 
normally  very  sensitive.  In  ulceration  and  when  inflamed 
sensitiveness  is  increased;  it  is  reduced  in  glaucoma.  Further 
examination  is  made  for  cuts,  scratches,  foreign  bodies,  etc. ' 

KERATITIS. 

Definition.  — An  inflammation  of  the  cornea.  Two  types 
are  recognized:  1.  Non-suppurative,  and  2,  suppurative 
keratitis.  Under  the  former  are  included  the  following 
forms:  (a)  Superficial,  (b)  vascular  (pannus),  (c)  keratitis 
pigmentosa,  (d)  keratitis  punctata  superficial,  (e)  parenchy- 


KE RAT IT IS  527 

matous,  (/)  keratitis  punctata  profunda.  Under  the  latter 
are  included:  (a)  Ulceration  of  the  cornea,  (6)  abscess  of  the 
cornea,  (c)  keratitis  neuroparalytica,  and  (d)  keratitis  from 
lagophthalmus. 

Non-suppurative  Keratitis. 

Superficial  Keratitis.— Definition.— An  inflammation  of  the 
cornea  which  involves  the  epithelial  layer  and  the  superficial 
layers  of  the  parenchyma.  It  is  very  commonly  due  to  acci- 
dents, injuries,  and  infections. 

Etiology.— Superficial  keratitis  may  result  from  (a)  a  spread 
of  infection  from  the  palpebral  or  scleral  conjunctiva.  (6) 
Wounds  on  the  cornea,  (c)  Foreign  bodies,  (d)  Chemical 
irritants,  such  as  too  strong  silver  preparations,  antisep- 
tics, etc.  The  common  practice  among  the  laity  of  using 
alum,  ammonia,  powdered  glass  in  turbidity  of  the  cornea 
obviously  often  injures  it.  (e)  Spreading  of  inflammation 
from  adjacent  structures,  such  as  the  iris  and  ciliary  bodies. 
(/)  Superficial  keratitis  is  often  observed  to  accompany  dog 
distempter  and  epitheliosis  of  fowls. 

Symptoms.— Lacrimation  and  photophobia  are  early  and 
prominent  symptoms.  Clouding  of  the  cornea  in  the  form  of 
a  bluish-white  film  is  seen  which  may  be  localized  or  general. 
An  epithelial  desquamation  is  often  produced  on  the  surface 
of  the  corneal  infiltration.  This  is  so  slight  in  many  cases 
that  it  is  not  recognized.  The  symptoms  usually  disappear 
completely  in  a  week  or  ten  days. 

Course.— The  course  is  usually  about  two  weeks. 

Prognosis.  —  Favorable  unless  complications  develop. 

Treatment.— A  careful  examination  should  be  made  of  all 
parts  of  the  eyelids  and  cornea  to  determine  the  conditions 
accurately.  Flush  the  cornea  and  conjunctiva  with  boric- 
acid  solution  (2  per  cent.),  or  chinosol  (1-2000  in  distilled 
water).  If  considerable  pain  and  photophobia  are  present 
a  cocain  and  atropin  solution  (1-150)  is  recommended.  A 
solution  of  succus  cineraria  maritima  compositus  (50  per 
cent.)  has  given  most  excellent  results.  Should  the  condition 
indicate  chronicity,  and  no  ulceration  be  present,  a  mild 


528  DISEASES  OF  THE  CORNEA 

solution  of  silver  nitrate  will  be  found  useful  to  change  the 
type  of  inflammation  and  to  act  as  an  antiseptic  and  astrin- 
gent. Daily  examination  and  treatment  must  be  carried  out 
until  the  opacity  disappears. 

Vascular  Keratitis. — Pannus.—  Definition.—  The  formation 
of  new  vascular  tissue  extending  over  the  cornea  just  under- 
neath the  epithelial  covering.  Pannus  is  not  frequent  in 
small  animals;  it  is  seen  occasionally  in  dogs. 

Etiology.— Pannus  occurs  in  most  instances  from  irritation 
of  a  severe  form  extending  over  a  long  period  of  time.  In 
dogs  it  commonly  results  from  chemical  irritation,  when 
strong  chemical  agents,  such  as  alum,  mercury,  etc.,  are  used 
in  treating  opacities  and  chronic  conjunctivitis.  It  may  be 
due  to  trichiasis  or  districhiasis,  and  is  also  a  sequel  to  chronic 
conjunctivitis,  or  may  occur  during  the  course  of  dog  dis- 
temper. 

Symptoms.— Pannus  usually  begins  with  photophobia  and 
lacrimation.  This  is  soon  followed  by  a  gray  or  white 
opacity,  traversed  by  numerous  bloodvessels  which  can  be 
easily  seen  extending  over  the  cornea  in  the  form  of  reddish, 
radiating  lines.  Later,  when  the  cause  is  removed,  the  new 
tissue  becomes  organized  and  appears  as  a  white  opacity  of 
varying  density. 

Prognosis.— Complete  recovery  is  difficult  to  attain  in  all 
cases.  The  prognosis  should  be  guarded  as  complications 
may  follow. 

Treatment.— A  careful  history  of  the  case  should  be 
obtained  in  order  to  determine  the  cause,  which  should  be 
removed,  if  possible.  If  opacity  is  present  a  solution  of 
succus  cineraria  maritima  compositus  (50  per  cent.)  is  recom- 
mended, using  a  few  drops  once  or  twice  daily.  Some  of  the 
various  ophthalmic  ointments  might  also  be  tried .  Operative 
procedure  is  recommended  in  case  the  ordinary  treatment 
fails.  The  pannus  may  be  removed  by  first  giving  the 
patient  a  general  or  local  anesthetic,  dilating  the  lids  with  an 
eye  speculum,  and  carefully  curetting  the  surface  with  a 
rather  dull  curette,  ("are  must  be  taken  to  prevent  curetting 
too  deep.  After  operating  apply  antiseptics,  and  in  severe 
cases  cover  the  eye  with  sterile  gauze  held  in  place  by  a  head 
bandage.  Daily  dressing  is  recommended. 


KERATITIS  529 

Keratitis  Pigmentosa. — Pigmentary  Keratitis.  —Definition. 
-A  chronic  disease  of  the  cornea,  either  inflammatory  or 
degenerative,  with  which  is  associated  pigment  deposit. 
It  has  been  observed  quite  often  in  certain  breeds  of  dogs 
and  cats.  The  poodle,  small  house  spaniel,  and  other  house 
dogs  are  the  most  common  sufferers. 

Etiology.— In  most  cases  pigmentary  keratitis  is  secondary 
to  ulceration  of  the  cornea,  other  forms  of  keratitis  and 
cornea!  opacities.  It  may  occur  as  a  primary  condition  in 
dogs  having  marked  pigment  deposits  along  the  corneal 
limbus.  In  these  cases  it  affects  usually  only  a  portion  of  the 
cornea,  but  may  extend  gradually  to  other  portions.  Occa- 
sionally the  pigmentation  may  be  deposited  around  the 
scleral  corneal  zone,  extending  toward  the  center  of  the 
cornea.  The  causes  of  the  primary  form  are  unknown. 

Symptoms.  — Pigmentary  keratitis  is  characterized  by 
deposits  of  melanin  or  pigment  in  the  cornea.  It  usually 
begins  as  a  fine,  triangular  network  of  small,  dark  lines 
radiating  from  the  limbus,  the  base  of  the  formation  being 
at  the  limbus  and  the  apex  directed  toward  the  center  of  the 
cornea.  The  triangular  pigment  formation  is  often  so  dense 
that  the  part  of  the  cornea  traversed  by  it  is  almost  black. 
Sometimes  the  pigmentation  disappears  to  reappear  later. 
Continued  recurrences  eventually  leave  the  cornea  dull  and 
uneven  on  its  surface.  Lacrimation  and  photophobia  are 
little  marked. 

Prognosis.— The  prognosis  is  unfavorable.  As  a  rule 
following  frequent  recurrences  permanent  opacity  of  the 
cornea  results. 

Treatment.— Boric  acid  (2  per  cent.),  or  ichthyol  (2  per 
cent.)  is  recommended.  Pain  may  be  arrested  by  stovain 
(2  per  cent.),  or  alypin  (2  per  cent.),  combined  with  the 
antiseptics.  Internally  potassium  iodid  (0.012-0.12)  once 
daily,  or  atoxyl  in  small  doses  has  been  used  with  apparent 
success.  The  patient  should  be  fed  liberally  and  given  good 


Keratitis  Punctata  Superficialis. — Facetted  Keratitis.— 
Definition.— A  chronic  inflammation  of  the  superficial  layer 
of  the  cornea  causing  opacity  and  the  appearance  of  small 

34 


530  DISEASES  OF  THE  CORNEA 

facets  occurring  singly  or  multiple.  This  disease  has  been 
observed  quite  often  in  certain  breeds  of  dogs  but  is  very 
rare  in  cats  and  birds. 

Etiology.— Nothing  definite  is  known  in  regard  to  its 
etiology.  Dogs  with  prominent  eyes  are  often  affected. 
It  has  been  observed  to  accompany  or  follow  rheumatic 
affections.  It  may  be  due  to  injuries,  infections,  specific  or 
general,  or  exposure. 

Symptoms.— Cloudiness  of  the  cornea  is  the  earliest  symp- 
tom. This  is  followed  soon  by  small,  opaque,  white,  gray 
or  yellow  spots  which  penetrate  into  the  parenchyma  of  the 
cornea.  Ulceration  of  one  or  more  turbid  areas  may  take 
place  causing  small  facets  to  appear.  Injection  of  the 
conjunctiva  and  scleral  membranes  is  a  prominent  symptom 
which  may  gradually  disappear  as  the  case  becomes  chronic. 
Lacrimation  and  photophobia  are  frequently  seen.  Owing 
to  the  disturbance  of  the  cornea  it  will  have  a  shagreened 
appearance. 

Prognosis  and  Course.— The  course  of  the  disease  is  chronic. 
The  symptoms  may  almost  completely  disappear  only  to 
recur.  Some  cases  show  a  tendency  to  become  periodic. 
The  prognosis,  therefore,  should  not  be  made  too  favorable. 

Treatment.— Flush  the  cornea  with  boric  acid  (2  per  cent.), 
chinosol  (1-500),  or  silver  nitrate  solution  (j  per  cent.). 
This  should  be  followed  immediately  with  a  few  drops  of  a 
solution  of  succus  cineraria  maritima  compositus  (50  per 
cent.).  This  treatment  should  be  continued  for  several  days 
or  weeks  to  obtain  the  best  results.  Some  of  the  ophthalmic 
ointments  may  be  tried  in  obstinate  cases. 

Parenchymatous  Keratitis.— Definition.— An  inflammation 
of  the  parenchyma  of  the  cornea,  characterized  by  a  diffuse 
infiltration  of  the  interstitial  tissue  with  a  vascularization 
of  the  sclera.  It  is  accompanied  in  most  cases  by  irido- 
cyclitis.  Parenchymatous  keratitis  is  a  very  common 
affection  in  dogs  but  rare  in  cats  and  birds. 

Etiology.— Infection  is  an  important  factor.  In  dogs  it 
follows  or  accompanies  distemper.  It  may  be  due  to  a 
spread  of  inflammation  from  the  iris  (iritis),  choroid  (choroid- 
itis),  etc.  Chronic  eczema,  mange,  etc.,  when  they  affect  the 


KERATITIS  531 

eyelids,  ear,  or  adjacent  parts,  may  be  attended  by  it.  Direct 
injury  to  the  cornea  may  be  a  cause. 

Symptoms.— The  cornea  becomes  turbid,  gray  or  yellow. 
The  normal  transparency  is  lost.  The  turbidity  may  not 
extend  over  the  entire  cornea.  Very'  often  a  dulness  of  the 
cornea  is  all  that  is  noticed  during  the  early  stages  of  the 
disease. 

When  the  cornea  is  closely  examined  there  will  be  found 
small  elevations  over  the  epithelial  layer,  and  a  network  of 
fine  bloodvessels  radiating  more  or  less  evenly  from  the 
periphery  to  the  center.  The  bloodvessels  are  often  so  small 
that  a  reading  glass  is  necessary  in  order  to  see  them.  They 
run  parallel  to  each  other  and  usually  do  not  anastomose 
but  terminate  in  a  small  loop  forming  a  zone  entirely  around 
the  corneal  limbus.  These  new  formed  vessels  become  quite 
extensive  and  involve  the  entire  cornea-  Lacrimation, 
photophobia,  pain,  and  congestion  of  the  sclera  are  present. 
When  examined  with  an  ophthalmoscope  there  will  be  evi- 
dence of  iritis  and  choroiditis. 

Course.— The  course  is  usually  several  days  to  a  few  weeks. 
Abscess  or  ulceration  of  the  cornea  is  a  rare  sequel. 

Prognosis. — Owing  to  the  changes  that  have  taken  place 
in  the  cornea,  it  requires  quite  a  long  time  to  bring  about 
healing.  The  tendency  to  recur  makes  the  prognosis  rather 
unfavorable.  Permanent  turbidity  of  the  cornea  may  result 
with  partial  or  complete  loss  of  sight. 

Treatment.— During  the  early  stages  of  the  disease  the 
patient  should  be  protected  from  strong  light  and  everything 
possible  done  to  prevent  irritation  of  the  cornea. 

( 'onstriction  of  the  vessels  and  reduction  of  the  irritation 
are  best  brought  about  by  applying  to  the  cornea  three  or 
four  times  daily  codrenin  solution  (4  per  cent.).  This  is 
continued  for  two  or  three  days.  When  there  is  evidence 
of  iritis  or  choroiditis  atropin  solution  (^  per  cent.)  is  of  value 
to  prevent  adhesions  (posterior  synechia). 

If  pus  is  present  a  mild,  non-irritating  antiseptic  should  be 
used.  Recommended  are  boric  acid  (2  per  cent.),  biniodid 
of  mercury  (1-10,000).  Codrenin  solution  may  be  added  to 
the  above  to  constrict  the  bloodvessels  and  control  the  pain. 


532  DISEASES  OF  THE  CORNEA 

When  the  condition  becomes  chronic  silver  preparations  are 
useful.  An  autogenic  vaccine  has  been  used  with  good 
results  and  may  be  given  every  four  or  five  days. 

Give  the  patient  plenty  of  good,  nourishing  food,  occasional 
laxatives,  and  small  daily  doses  of  potassium  iodid  (0.016- 
0.032). 

Keratitis  Punctata  Profunda.  —Definition.  —An  inflamma- 
tion of  the  deeper  layer  of  the  cornea  appearing  in  the  form 
of  multiple,  small  spots.  It  is  more  common  in  the  horse  and 
dog  than  in  other  animals. 

Etiology.— The  cause  has  not  been  determined.  It  may  be 
produced  by  specific  infection  and  inflammation  spreading 
from  adjacent  parts. 

Symptoms.—  Numerous  small  opacities  or  spots  are  noted 
in  the  depths  of  the  cornea.  They  are  visible  to  the  naked 
eye,  or  are  seen  better  with  a  reading  glass,  with  oblique  or 
direct  illumination.  The  spots  are  mostly  circular,  well 
defined,  evenly  distributed,  or  more  or  less  grouped.  In 
color  they  are  usually  white,  occasionally  darker.  The  rest 
of  the  eye  appears  normal. 

Prognosis. — Unfavorable. 

Treatment. —No  treatment  is  of  avail. 

Suppurative  Keratitis. 

Ulceration  of  the  Cornea.— Definition.— A  destruction  of 
the  substance  of  the  cornea,  the  result  of  infection  with  pus. 
The  ulcers  vary  in  size,  some  are  not  larger  than  a  pin  point; 
others  involve  a  large  part  of  the  cornea. 

Etiology.— The  causes  of  ulceration  are  varied.  Wounds 
of  the  cornea,  even  though  slight,  form  ports  of  entry  for 
infection.  In  small  animals  the  cornea  is  frequently  injured 
by  foreign  Kodies  which  enter  the  lid  sac,  by  being  bitten  or 
scratched  by  other  animals,  or  from  an  inversion  of  the 
eyelashes. 

The  undue  exposure  of  the  cornea  which  accompanies 
lagophthalmus,  exophthalmus,  and  paralysis  of  the  fifth 
nerve  is  a  predisposing  cause.  Ulceration  of  the  cornea 
accompanying  or  following  infectious  diseases,  especially 


KERATITIS  533 

distemper  of  the  dog  and  oat,  is  not  infrequent.  Purulent 
infection  of  the  conjunctiva  (palpebral,  scleral,  corneal)  may 
lead  to  ulceration.  The  microorganisms  most  frequently 
found  are  streptococci,  staphylococci,  pneumococci,  and  other 
pyogenic  germs. 

The  infection  producing  ulceration  is  no  doubt  in  many 
cases  carried  by  the  blood  to  the  cornea,  and  by  the  lymph 
into  the  cornea.  Many  diseases  which  reduce  corneal 
resistance  predispose  to  ulceration,  such  as  chronic  constitu- 
tional diseases,  and  some  infectious  diseases.  In  birds 
suppuration  of  the  lacrimal  passages  and  conjunctiva  leads 
to  ulceration  as  is  frequently  noted  in  epitheliosis.  This 
form  commonly  leads  to  perforation  of  the  cornea. 

Symptoms.  — Corneal  ulcers  vary  considerably  in  size,  form 
and  depth.  Any  portion  of  the  cornea  may  be  the  seat  of 
one  or  more  of  them.  Jn  most  cases,  however,  ulcers  are 
found  at  or  near  the  center  of  the  cornea.  In  form  they  are 
mostly  round  with  well  defined,  sharp  borders  as  if  cut  out 
with  a  sharp  instrument.  In  other  cases  their  form  is 
irregular.  The  base  of  the  ulcer  may  be  flat,  concave,  or 
convex;  rough,  vascular,  or  infiltrated.  The  cornea  sur- 
rounding the  ulcer  is  usually  turbid,  and  secondary  ulcers 
not  uncommonly  develop.  Uleeration  of  the  cornea  accom- 
panying dog  distemper  often  occurs  suddenly,  tends  to  spread 
rapidly  and  not  infrequently  leads  to  perforation  in  a  few 
days.  Photophobia,  lamination,  and  congestion  of  the 
adjacent  structures  are  nearly  always  present.  Frequently 
a  copious  discharge  of  pus  occurs  from  the  affected  eye. 
Pain  may  or  may  not  be  a  prominent  symptom,  depending 
upon  the  cause  of  the  ulcer  and  to  what  extent  other  struc- 
tures of  the  eye  are  involved. 

Course.— The  usual  course  is  chronic.  Some  cases  require 
several  weeks  for  complete  disappearance.  The  ulcer  may 
disappear  without  trace,  or  it  may  lead  to  perforation,  or 
cicatrization  and  permanent  opacity. 

Prognosis.— Ulceration  of  the  cornea  is  always  serious. 
Perforation,  panophthalmitis,  or  opacity  often  follow  it.  Its 
chronicity  and  tendency  to  recurrence  make  the  prognosis 
always  guarded. 


534  DISEASES  OF  THE  CORNEA 

Treatment.— Flush  the  corneal  surface  with  a  mild  anti- 
septic solution  (boric  acid,  2  per  cent.;  ichthyol,  2  per  cent.). 
If  pain  is  present,  drop  into  the  eye  a  small  amount  of  cocain, 
stovain  or  alypin  solution,  to  reduce  the  irritation  and 
prevent  further  injury  by  the  patient  rubbing  or  scratching 
the  affected  eye.  This  treatment  will  control  the  general 
infection  preventing  further  spread  of  the  ulcer.  Where  pus 
formation  is  copious  (blennorrhea)  an  autogenic  vaccine 
may  be  prepared  and  used  in  conjunction  with  the  other 
treatment. 

Direct  treatment  of  the  ulcer  requires  judgment  and  care. 
Careful  curetting  followed  by  applying  protargol  solution 
(5  per  cent.)  is  recommended.  Good  results  have  followed 
the  use  of  succus  cineraria  maritima  compositus  (50  per  cent.). 

When  the  ulcer  shows  a  tendency  to  perforate  an  anti- 
septic pack  should  be  applied  to  the  eye  (eyelids  closed), 
and  a  head  bandage  to  hold  it  in  place.  This  will  exert 
outside  pressure  and  may  prevent  perforation,  permitting  in 
the  meantime  new  formed  granulation  tissue  to  strengthen 
the  defect.  Lead  and  silver  solutions  should  not  be  used 
too  strong  on  account  of  the  danger  of  permanent  deposits 
resulting.  Treatment  should  be  applied  daily. 

Abscess  of  the  Cornea.— Definition.— A  collection  of  pus  in 
the  cornea.  Corneal  abscesses  are  very  common  in  dogs. 

Etiology.— Infection  with  pus  organisms  usually  through 
wounds  or  abrasions.  Foreign  bodies,  bites  and  scratches 
pave  the  way  for  an  infection  which  results  in  abscess. 
Corneal  abscesses  commonly  result  from  distemper  of  the 
dog  and  cat,  and  epitheliosis  in  birds. 

Symptoms.— The  first  symptoms  noted  are  discharge  of 
pus  from  the  affected  eye,  photophobia,  and  a  tendency  to 
rub  the  eye  with  the  paws.  On  examination  a  yellow, 
sharply  defined  abscess  from  the  size  of  a  pin-point  to  a  wheat 
grain  or  larger  is  noted  near  the  center  of  the  cornea.  The 
cornea  surrounding  the  abscess  may  be  transparent  but  is 
often  turbid.  As  the  abscess  ages  new  formed  bloodvessels 
are  projected  from  the  corneal  bloodvessels  across  the  cornea 
to  the  abscess.  Surrounding  the  abscess  a  bloodvessel 
appears.  If  the  abscess  is  large,  or  a  number  of  small 


FOREIGN  BODIES  AND  WOUNDS  OF  THE  CORNEA     535 

abscesses  are  present,  the  curvature  of  the  cornea  becomes 
stronger,  sometimes  cone-shaped.  Conjunctivitis,  conges- 
tion of  the  episcleral  bloodvessels,  and  profuse  lacrimation 
accompany  the  abscess. 

Course.— Most  cases  require  several  weeks  for  complete 
recovery.  As  a  rule  the  abscess  ruptures  outwardly;  occa- 
sionally inwardly,  discharging  the  pus  into  the  anterior 
chamber  causing  hypopyon  and  in  some  cases  suppurative 
panophthalmitis.  Corneal  ulcer  may  result  from  the  abscess. 

Prognosis.— On  account  of  the  danger  of  serious  complica- 
tions, the  prognosis  should  be  guarded.  It  is  possible  for 
the  corneal  abscess  to  heal  without  trace. 

Treatment.— To  remove  surface  infection  warm,  antiseptic 
solutions  (boric  acid,  2  per  cent.;  ichthyol,  3  per  cent.)  may 
be  used.  Pain  is  controlled  by  cocain,  stovain,  alypin  or 
codrenin.  The  abscess  may  be  opened  under  strict  antiseptic 
precautions  and  the  cavity  treated  with  protargol  solution 
(5  per  cent.).  Treatment  should  be  made  daily. 

Keratitis  Neuroparalytica.— Definition.— A  rare  affection  in 
animals  due  to  a  paralysis  of  nerves  (trigeminal,  ciliary)  lead- 
ing to  undue  exposure  of  the  cornea.  (See  larger  works.) 

Keratitis  from  Lagophthalmus.— Definition.— An  inflam- 
mation of  the  cornea  resulting  from  incomplete  closing  of  the 
eyelids.  The  portions  of  the  cornea  not  protected  by  the 
lid  become  dry,  opaque,  and  ulcerated.  Hypopyon,  iritis 
and  panophthalmitis  frequently  result. 

Treatment.— Besides  keeping  the  parts  lubricated  with 
glycerized  antiseptics  nothing  can  be  done. 

FOREIGN  BODIES  AND  WOUNDS  OF  THE  CORNEA. 

Foreign  bodies  frequently  enter  the  eyes  of  animals.  Occa- 
sionally they  become  imbedded  producing  usually  infected 
wounds  of  the  cornea.  Wounds  also  result  from  bites  or 
scratches  of  other  animals. 

Symptoms.— The  symptoms  of  lacrimation,  photophobia 
and  pain  develop  suddenly  following  the  injury.  The 
examination  of  the  eye  should  be  made  thorough,  everting 
the  lids  and  nictating  membrane,  in  order  that  foreign 
bodies  will  not  be  overlooked. 


53G  DISEASES  OF  THE  CORNEA 

Prognosis.— Providing  too  much  injury  has  not  been 
wrought  by  the  offending  foreign  body,  the  prognosis  is 
favorable.  In  making  the  prognosis  one  should  bear  in  mind 
complications  resulting  from  probable  infection. 

Treatment.— Flush  the  eye  with  mild  antiseptic  solutions 
(boric  acid,  2  per  cent. ;  ichthyol,  2  per  cent. ;  chinosol,  1-2000). 
Foreign  bodies  must  be  removed.  Further  treatment  will 
depend  upon  the  progress  of  the  case.  The  affected  eye 
should  be  watched  carefully  and  threatened  complications 
promptly  treated.  Some  wounds  require  careful  handling 
in  order  to  prevent  perforation. 

OPACITIES  OF  THE  CORNEA. 

Most  opacities  of  the  cornea  result  from  inflammation. 
Those  resulting  from  other  causes  are  very  rare  in  animals. 
The  majority  follow  wounds,  ulcers,  irritant  chemicals 
instilled  into  the  eye,  or  burns. 

Depending  upon  their  density,  various  terms  have  been 
applied  to  opacities:  (a)  Nebula,  a  slight  turbidity.  The 
cornea  appears  blue  or  slightly  foggy.  (6)  Macula,  a  denser 
opacity  easily  seen  in  ordinary  light.  It  may  be  milk  white. 
(c)  Albugo,  a  translucent  opacity,  (d)  Leukoma,  the  entire 
cornea  becoming  turbid,  milk  white.  It  may  be  either  con- 
genital or  acquired. 

Prognosis.— The  prognosis  depends  upon  the  age  of  the 
patient,  duration,  location,  extent  and  character  of  the 
opacity.  The  more  recent  the  opacity,  the  more  favorable 
the  prognosis.  Superficial  opacities  are  more  readily  removed 
than  deeper  ones.  However,  the  prognosis  should  be 
guarded. 

Treatment.— As  most  opacities  of  the  cornea  are  composed 
of  cicatricial  tissue  complete  removal  of  them  is  very  difficult. 
However,  some  of  them  will  entirely  disappear  and  the  cornea 
reassume  its  former  transparency.  The  following  agents  are 
recommended:  Dionin  solution  (o  to  10  per  cent.),  or  in  the 
form  of  powder,  has  given  excellent  results.  Begin  with  a 
few  drops  of  a  5  per  cent,  solutjon  instilled  two  or  three 
times  daily.  The  strength  of  the  preparation  may  be 


ECTASIA  OF  THE  CORNEA  537 

increased  later  if  necessary.  A  severe  reaction  usually  follows 
the  first  treatments.  This  disappears  later  when  the  strength 
of  the  solution  can  be  increased.  Red  or  yellow  oxid  of 
mercury  ointment  has  also  been  used  with  good  results. 
A  small  quantity  is  applied  once  daily.  Silver  nitrate 
solution  (4  per  cent.),  or  protargol  (10  per  cent.)  is  used  to 
stimulate  greater  cellular  activity  in  the  region  of  the  opacity. 
Succus  cineraria  maritima  compositus  is  also  of  value.  To 
obtain  results  treatment  must  be  continued  for  a  long  time. 
As  a  last  resort,  when  medical  treatment  does  not  suffice, 
iridectomy  may  be  tried.  The  operation  consists  in  making 
an  artificial  pupil  so  situated  that  light  may  reach  the 
retina. 

ECTASIA  OF  THE  CORNEA. 

Two  types  of  ectasia  are  recognized:  (a)  Inflammatory 
ectasia,  and  (b)  non-inflammatory  ectasia. 

Inflammatory  Ectasia. — Two  forms  occur  in  animals,  viz.: 
Staphyloma,  and  keratectasia. 

Staphyloma.— Definition.— A  protrusion  of  the  cornea,  the 
result  of  inflammation  (ulceration,  perforation,  prolapsus  of 
iris).  Staphyloma  may  be  partial  or  complete;  in  form 
spherical  or  conical.  In  animals  it  is  usually  complete  the 
entire  cornea  protruding  from  the  scleral  margin.  In  color 
it  is  blue  or  black  due  to  cellular  infiltration  and  pigment 
deposit.  The  protrusion  may  interfere  with  the  closing  of 
the  lids.  Lacrimation,  photophobia  and  pain  are  prominent 
symptoms.  In  the  incomplete  form  (conical)  only  a  portion 
of  the  cornea  protrudes. 

7 'reatment.— Treatment  is  usually  unsatisfactory.  The 
cause  should  be  removed  if  possible.  Apply  gentle  pressure 
to  the  eye  through  antiseptic  packs  retained  with  a  head 
bandage.  When  the  intra-ocular  pressure  is  too  great,  some 
of  the  fluid  from  the  anterior  chamber  may  be  aspirated 
before  applying  the  pack.  Permanent  satisfactory  results 
can  hardly  be  hoped  for.  When  other  treatment  fails  the 
afl'ected  eye  should  be  enucleated. 

Keratectasia. — Definition. — Keratectasia  involves  only  the 
cornea  which  has  become  weakened  at  some  point  either  from 


538  DISEASE*  OF  THE  CORNEA 

infiltration  or  from  an  ulcer  which  has  not  perforated  its 
entire  thickness.  In  keratectasia  the  iris  is  not  involved  as 
in  staphyloma. 

Treatment— Relieve  the  intra-ocular  tension  and  apply  a 
compress.  Iridectomy  may  be  useful  in  some  cases. 

Non-inflammatory  Ectasia.— Two  forms  are  recognized: 
Keratoconus,  and  keratoglobus. 

Keratoconus.— A  cone-shaped  protrusion  of  the  cornea 
which  does  not  become  opaque.  It  results  from  a  weakening 
of  the  cornea  at  its  center  and  an  increase  in  intra-ocular 
tension.  The  condition  is  incurable. 

Keratoglobus.— The  entire  cornea  is  enlarged  as  the  result 
of  a  general  increase  in  size  of  the  entire  eyeball.  It  is  seen 
in  hydrophthalmus.  The  cornea  retains  its  transparency. 
The  condition  is  usually  congenital  and  most  often  observed 
in  young  dogs  and  young  cats. 

Treatment.— No  treatment  is  of  any  value. 

TUMORS  OF  THE  CORNEA. 

Tumors  of  the  cornea  are  rare  in  animals.  Dermoids  are 
occasionally  met  with  in  dogs  and  cats.  Sarcomas  and 
carcinomas  have  been  noted.  They  usually  originate  either 
in  some  other  part  of  the  eye  or  in  adjacent  tissues. 

Treatment.— Surgical  treatment  should  be  attempted  as 
early  as  possible.  No  treatment  should  be  attempted  in 
malignant  tumors. 


CHAPTER  V. 
DISEASES  OF  THE  IRIS  AND  CILIARY  BODY. 

General.— In  practice  it  is  very  difficult  to  separate  the 
diseases  of  the  iris  and  ciliary  body  of  which  the  iris  is 
practically  an  extension.  The  structure  of  the  iris  is  much 
the  same  in  all  animals.  The  arrangement  of  its  muscular 
fibers  in  different  animals  accounts  for  the  variation  in  the 
shape  of  the  pupil.  In  the  cat  the  pupil  is  an  elongated 
slit;  in  dogs  it  is  spherical  or  oval. 

The  color  of  the  iris  is  due  to  the  quantity  of  pigme  nt 
present  in  the  posterior  layers  and  in  the  membrane  proper. 
Frequently  the  pigment  is  entirely  absent  producing  the 
albino  or  pink  eye.  This  is  common  in  rabbits  and  is 
occasionally  observed  in  other  animals.  The  other  colors, 
such  as  blue,  black  or  gray  eyes,  are  determined  by  the 
amount  and  distribution  of  the  pigment.  A  more  com- 
plete examination  of  the  iris  can  be  made  if  a  few  drops  of 
eserin  are  instilled  into  the  eye  to  contract  the  pupil.  The 
examination  should  be  made  for  congenital  defects,  inflam- 
mations, tumors,  etc. 

CONGENITAL  DEFECTS  OF  THE  IBIS. 

A  number  of  defects  in  the  formation  and  development 
of  the  iris  has  been  observed:  (a)  Occlusion  of  the  pupil, 
occurring  in  the  dog,  cat  and  rabbit,  causing  congenital 
blindness.  (6)  Ectopia  pupillse,  a  displacement  of  the 
pupil  often  found  accompanying  luxation  of  the  lens,  (c) 
Toloboma,  a  portion  of  the  iris  failing  causing  a  large, 
irregular-shaped  opening,  (d)  Aniridia,  absence  of  the  iris, 
very  unusual  in  animals.  Treatment  for  these  conditions 
is  unsatisfactory.  The  size  and  form  of  the  pupil  are 
influenced  by  light,  disease  and  medication. 


540     DISEASES  OF  THE  IRIS  AND  CILIARY  BODY 

MYDRIASIS. 

Definition.— A  dilatation  of  the  pupil.  It  may  be  due  to: 
(a)  Paralysis  of  the  third  nerve,  (6)  disease  of  the  central 
nervous  system,  (c)  constitutional  diseases,  (rf)  poisons,  (e) 
mydriatics. 

Mydriasis  is  produced  artificially  in  order  to  examine 
the  interior  of  the  eye. 

MYOSIS. 

Definition.— A  contraction  of  the  pupil.  It  is  caused  by 
paralysis  of  the  cervical  sympathetic  nerves,  tabes  dorsalis, 
inflammation  of  the  iris,  foreign  bodies  in  the  cornea  and  by 
myotic  drugs  (morphin,  codrenin,  eserin).  It  is  frequently 
noted  in  rabkr"animals. 

IRITIS  AND  CYCLITIS.     IRIDOCYCLITIS. 

Definition. — An  inflammation  of  the  iris  and  of  the  ciliary 
body.  They  usually  co-exist  and  will  be  therefore  con- 
sidered together  (iridocyclitis). 

Etiology.— Traumatism.  A  primary  iridocyclitis  is  not 
common.  Most  cases  are  secondary  to  other  diseases, 
such  as  distemper  of  the  dog  and  cat. 

Symptoms.  —  Iridocyclitis  is  characterized  by  congestion, 
discoloration,  loss  of  the  normal  striations  and  inability 
of  the  iris  to  react  to  light  or  other  stimulae.  The  pupil  is 
usually  found  contracted.  While  it  is  possible  for  the 
iridian  exudate  to  be  very  limited,  the  inflammation  stopping 
in  the  congestive  stage,  as  a  rule,  it  is  profuse,  falls  off 
the  iris  and  accumulates  in  the  anterior  chamber  (hypopyon 
if  purulent).  The  exudate,  which  is  usually  fibrinous,  may 
be  seen  through  the  cornea  as  a  movable,  yellow,  sometimes 
blood-streaked  accumulation  floating  in  the  anterior  cham- 
ber. If  an  adhesion  between  the  iris  and  the  cornea  results, 
anterior  synechia  is  spoken  of;  if  between  the  iris  and  lens, 
posterior  synechia.  Symptoms  of  lacrimation,  photophobia 
and  congestion  of  the  conjunctiva  are  usually  present.  The 
cornea  is  nearly  always  involved,  appearing  as  if  lightly 
greased  over  its  surface.  When  the  ciliary  bodies  are 


CYSTS  AND  TUMORS  OF  THE  IRIS  541 

prominently  involved  a  turbidity  of  the  corneal  margins  is 
noted.  Exudate,  which  has  passed  through  the  pupil, 
reaches  the  anterior  chamber  producing  the  same  symptoms 
as  iridian  exudate.  The  iris  may  be  only  slightly  involved 
as  is  determined  by  its  color,  striations  and  reaction  to 
light. 

Course.  —The  course  in  iridocyclitis  is  usually  short.  The 
inflammation  rapidly  subsides  and  the  exudate  is  quickly 
resorbed.  A  few  cases  become  chronic  and  lead  to  posterior 
synechia. 

Prognosis.— In  uncomplicated  cases  the  prognosis  is  favor- 
able. When  the  choroid  or  retina  is  involved  the  prognosis 
is  guarded. 

Treatment. —When  secondary  to  constitutional  diseases, 
distemper,  etc.,  these  should  receive  attention.  Local 
treatment  consists  in  instilling  atropin  solution  (0.5  to  1 
per  cent.)  once  or  twice  daily,  which  paralyzes  the  accom- 
modation, relieves  pain  and  congestion  and  prevents  adhe- 
sions. Dionin  solution  (4  per  cent.)  is  also  useful  to  stimulate 
the  lymph  circulation.  Hot  applications  in  the  form  of  a 
hot-water  compress  are  of  great  service.  They  should  be 
applied  for  an  hour  at  a  time  during  the  first  twenty-four 
to  thirty-six  hours.  Antiseptic  and  astringent  solutions, 
such  as  succus  cineraria  maritima  compositus  (50  per  cent.), 
or  ichthyol  (4  per  cent.)  may  also  be  used.  Complications 
should  be  treated  as  they  arise. 

CYSTS  AND  TUMORS  OF  THE  IRIS. 

Cysts  involving  the  iris  are  quite  rare.  They  most  often 
result  from  injury  and  appear  as  enlargements  on  the  iris. 
It  is  difficult  to  distinguish  between  cysts  and  tumors. 
They  are  treated  by  puncturing,  under  antiseptic  precau- 
tions, with  a  knife  needle  inserted  through  the  corneal 
margin. 

Both  benign  and  malignant  tumors  may  involve  the  iris. 
Melanoma  is  the  most  frequent  primary  tumor.  Sarcomas 
and  carcinomas  also  occur.  They  usually  extend  from 
adjacent  structures  which  are  their  primary  seats.  Treat- 
ment consists  in  enucleating  the  eyeball. 


CHAPTER  VI. 
DISEASES  OF  THE  LENS. 

Examination. —The  lens  is  best  examined  after  dilating 
the  pupil  with  atropin.  The  patient  should  be  placed  in 
a  good  light  or  light  may  be  reflected  with  an  ophthalmo- 
scope against  the  lens.  Normally  the  lens  is  transparent. 
It  should  be  examined  for  turbidity,  position  and  form. 
In  old  dogs  the  lens  is  usually  less  transparent  than  in 
younger  animals. 

CATARACT. 

Definition.— An  opacity  of  the  lens,  its  capsule  or  both. 
Cataract  is  common  in  the  dog  and  cat,  especially  in  old 
animals.  The  following  kinds  occur:  (a)  Symptomatic, 
(6)  traumatic,  (c)  senile,  (d)  diabetic,  (e)  congenital. 

Symptomatic  Cataract.— This  form  results  from  an  inflam- 
mation of  some  of  the  adjacent  structures  which  interferes 
with  the  nutrition  of  the  lens.  In  the  dog  and  cat  it  often 
develops  from  distemper. 

Traumatic  Cataract.— Traumatic  cataract  is  caused  by 
injury  to  the  lens  by  sharp  objects  which  penetrate  the 
cornea.  Or  it  may  be  due  to  indirect  injury,  the  animal 
receiving  a  blow  which  jars  the  lens  from  its  fastenings.  It 
may,  therefore,  result  from  fracture  of  the  orbit  or  some  of 
the  other  bones  of  the  head. 

Senile  Cataract.— Common  in  old  dogs.  It  is  due  to  an 
atrophy  of  the  lens  and  is  usually  bilateral.  In  the  early 
stages  senile  cataract  usually  appears  as  radiating,  gray 
lines  which  extend  from  the  periphery  to  the  center  of  the 
lens.  In  other  cases  it  may  occur  as  an  opaque  spot  or 
spots  in  the  lens.  The  opacity  spreads  until  eventually  the 
entire  lens  is  involved. 


CATARACT  543 

Diabetic  Cataract.— Very  rare  in  animals.  A  few  cases  have 
been  noted  in  dogs. 

Congenital  Cataract.— Quite  common  in  young  dogs.  As 
a  rule,  the  lens  only  is  involved.  It  is  often  bilateral.  •  It 
may  be  partial  or  complete. 

Symptoms.— General.— In  animals  cataract  is  usually  over- 
looked until  it  becomes  so  well  marked  as  to  be  visible  to  the 
ordinary  observer.  Partial  cases  are  sometimes  discovered 
during  an  examination  of  the  eye  for  some  other  disease.  In 
using  the  ophthalmoscope  in  cataract  the  light  should  not  be 
too  strong.  Under  subdued  light  the  opacity  appears  as  a  dark 
spot,  its  color  differentiating  it  from  the  tapetum  lucidum  or 
the  red  papilla.  Cataract  should  be  distinguished  from  foreign 
bodies  on  the  cornea,  corneal  opacities  and  turbidity  of  the 
vitreous  humor.  In  most  cases  a  careful  examination  with 
an  ophthalmoscope  will  suffice  to  differentiate  between  lens 
opacities  and  those  in  other  parts  of  the  eye.  When  the 
diagnosis  cataract  has  been  made,  the  form  and  cause 
should  be  determined  whenever  possible.  The  history  of 
the  case,  the  age  and  condition  of  the  patient,  and  the 
appearance  of  the  opacity  are  indicative. 

Course.—  The  course  in  cataract  is  chronic,  usually  lead- 
ing to  complete  loss  of  vision.  Occasionally  a  traumatic 
cataract  develops  rapidly  and  undergoes  a  spontaneous 
recovery  within  a  short  time.  Such  cases  are  rare. 

Prognosis.— The  prognosis  is  unfavorable. 

Treatment.— The  only  treatment  of  value  is  an  opera- 
tion to  remove  the  lens.  In  veterinary  practice  the  diffi- 
culty in  keeping  the  parts  aseptic,  the  dressings  in  place 
and  the  patient-  quiet,  is  so  great  that  cataract  operations 
are  seldom  employed.  There  are  two  operations  for  cata- 
ract: (a)  A  discission  of  the  lens,  and  (6)  extraction  of  the 
lens. 

Discission. — Discission  is  practised  only  in  congenital 
cataract,  or  when  cataract  appears  early  in  life,  is  soft  and 
capable  of  absorption.  The  operation  is  performed  under 
complete  anesthesia  and  strict  asepsis.  The  eye  to  be 
operated  is  flushed  out  with  an  antiseptic  solution  (boric 
acid,  2  per  cent.;  bichlorid  of  mercury,  l-5000)s  followed 


544  DISEASES  OF  THE  LENS 

by  a  solution  of  atropin  (1  per  cent.)  to  dilate  the  pupil. 
The  lids  are  held  open  with  an  eye  speculum.  With  a 
special  instrument,  a  small  knife-needle,  which  is  passed 
through  the  cornea  at  its  margin  and  pushed  diagonally 
through  the  lens  capsule  into  the  lens  proper,  the  lens  is 
cut  and  separated.  The  instrument  is  then  withdrawn 
carefully  so  as  to  avoid  injury  to  the  cornea.  An  absorp- 
tion of  the  lens  should  follow.  If  not,  the  operation  may  be 
repeated  in  a  few  weeks. 

Complications,  such  as  swelling  of  the  lens  and  increased 
intra-ocular  tension  with  severe  pain,  may  follow  the  opera- 
tion. Cold  packs  are  recommended  to  reduce  the  swelling. 
If  they  afford  no  relief  within  a  short  time  the  cornea  may 
be  punctured  at  its  margin  which  relieves  the  tension. 
Through  the  same  opening  the  lens  substance  may  be 
removed.  If  iritis  result  from  particles  of  the  lens  coming 
in  contact  with  the  iris,  instil  atropin  solution  and  apply 
hot  packs. 

Extraction. — The  lens  is  extracted  in  all  cases  when  the 
discission  operation  is  contra-indicated.  The  technic  of 
the  operation  is  rather  difficult  and  requires  much  practice. 
It  consists  briefly  in  incising  the  cornea  in  the  sclerocorneal 
limbus,  fixing  the  eyeball  with  a  special  fixation  forceps, 
incising  the  capsule  of  the  lens,  and  expressing  the  lens. 
The  eye  should  be  cleansed  and  a  dressing  applied.  Many 
complications  may  follow  the  operation  in  animals: 
Panophthalmitis,  prolapse  of  the  iris;  iritis  and  cyclitis  in 
a  small  percentage  of  cases.  Proper  and  careful  dressing  of 
the  wound  after  the  operation  is  especially  important. 

LUXATION  OF  THE  LENS. 

Luxation  is  not  very  frequent  in  small  animals.  In  most 
instances  it  results  from  traumatism.  It  may  be  due  to 
extreme  intra-ocular  tension  in  either  chamber  of  the  eye, 
or  from  rupture  of  the  suspensory  ligaments  of  the  lens. 
The  luxation  may  be  partial  or  complete;  into  the  anterior 
or  posterior  chamber. 

Treatment.— Treatment  is  of  no  value.  A  removal  of  the 
lens  is  occasionally  employed. 


CHAPTER  VII. 
DISEASES  OF  THE  RETINA  AND  CHOROID. 

THESE  membranes  can  be  seen  only  with  the  ophthalmo- 
scope. It  is  best  to  dilate  the  pupil  in  order  to  increase 
the  size  of  the  field  of  the  eye's  background. 

The  following  pathological  changes  may  be  noted  on  the 
retina:  (a)  Hyperemia,  (6)  edema,  (c)  inflammation  (retin- 
itis),  (d)  detachment  of  the  retina,  (e)  anemia,  (/)  atrophy. 

Hyperemia. — A  congestion  of  the  retina.  The  blood- 
vessels will  be  found  dilated  and  engorged  with  blood. 

Edema.— Rare  in  animals.  It  may  result  from  direct 
injury,  or  inflammatory  exudate  which  collects  in  the  retina. 
The  retina  appears  cloudy. 

Inflammation  (Retinitis).—A.n  inflammation  of  the  retina. 
It  usually  develops  during  or  as  a  sequel  to  infectious  or 
chronic  constitutional  diseases.  It  is  characterized  by  hyper- 
emia,  edema,  partial  or  complete  obliteration  of  the  papilla 
and  hemorrhage. 

Detachment  of  the  Retina.-—  Rare  in  animals.  It  may  result 
from  an  accumulation  of  exudate  or  transudate  between 
the  retina  and  choroid,  which  causes  the  retina  to  become 
detached  and  float  loose  in  the  vitreous  humor.  It  causes 
partial  or  complete  blindness. 

Anemia.— Retinal  anemia  usually  results  from  general 
hemorrhage;  obviously  it  accompanies  general  anemia.  It 
may  have  a  local  origin,  the  bloodvessels  supplying  the 
retina  becoming  blocked  and  pressed  upon  by  tumors  or 
inflammatory  growths.  The  retina  appears  pale  and  the 
bloodvessels  reduced  in  size. 

Atrophy,— Usually  follows  extensive  and  severe  retinitis; 
or  when  the  nutrition  of  the  retina  has  become  reduced. 
The  bloodvessels  appear  unusually  small;  in  some  cases 
hardly  visible. 

The  diseases  of  the  choroid  are  so  intimately  interwoven 
with  those  of  the  other  membranes  that  a  separate  descrip- 
tion is  unnecessary. 
35 


CHAPTER  VIII. 
DISEASES  OF  THE  OPTIC  NERVE. 

USUALLY  when  the  optic  nerve  is  affected  diseases  of 
other  structures,  particularly  of  the  retina,  co-exist. 

The  principal  pathological  changes  affecting  the  optic 
nerve  are:  (a)  Wounds,  (6)  hemorrhages,  (c)  inflammation, 
(d)  tumors. 

The  optic  nerve  is  also  affected  by  inflammation  of  adja- 
cent structures,  and  diseases  of  the  central  nervous  system. 

The  diseases  of  the  optic  nerve  usually  noted  are:  (a) 
Papillitis,  (6)  retrobulbar  neuritis,  (c)  atrophy.  Clinically 
amblyopia  and  amaurosis  are  recognized. 

PAPILLITIS. 

Definition.— An  inflammation  of  the  papilla.  It  may  be 
unilateral  or  bilateral.  It  is  usually  caused  by  poisons, 
traumatism  and  diseases  of  the  central  nervous  system. 
Viewed  with  the  ophthalmoscope  the  papilla  appears  either 
enlarged  and  engorged  with  blood  or,  on  the  other  hand,  too 
pale— even  white  in  color.  Its  outline  is  usually  indistinct 
and  striations  are  seen  radiating  from  its  center.  When 
due  to  tumors  and  marked  congestion  is  present,  the  papilla 
appears  intensely  red  ("choked  disk"). 

Prognosis.— The  prognosis  is  unfavorable.  Partial  or  com- 
plete blindness  will  usually  result. 

RETROBULBAR  NEURITIS. 

Definition. —An  inflammation  of  the  optic  nerve  just 
posterior  to  its  entrance  into  the  eyeball.  It  may  result 
from  injuries,  infection  through  wounds  involving  the 
orbit;  or  attend  nasal  catarrh,  or  dog  distemper  which  has 


AMAUROSIS  547 

attacked  the  sinuses  of  the  head.  The  patient  is  partially 
or  totally  blind.  The  papilla  will  appear  congested.  Many 
cases  will  recover  when  the  cause  is  removed. 

ATROPHY  OF  THE  OPTIC  NERVE. 

Definition.  — It  may  result  from  inflammation  or  be  a  simple 
atrophy.     Blindness  is  a  prominent  symptom. 
Prognosis.— The  prognosis  is  unfavorable. 

AMBLYOPIA. 

Definition.  —  Partial  blindness.  No  lesion  can  be  deter- 
mined. In  animals  it  usually  results  from  poisoning.  As  a 
rule  when  the  cause  is  removed  sight  is  restored. 

AMAUROSIS. 

Definition.  — Blindness  without  visible  lesion  of  the  eye. 
Amaurosis  is  a  symptom  and  not  a  disease.  The  term  is 
falling  into  disuse  as  ophthahnoscopy  becomes  better 
developed.  It  may  be  congenital  or  acquired.  Diseases 
of  the  optic  nerve,  retina,  brain  and  certain  poisons  are  its 
principal  causes.  The  symptoms  are  blindness,  abnormal 
dilatation  of  the  pupil  which  does  not  react  to  light.  In 
the  early  stages  the  eye  appears  normal  but  in  time  the 
globe  becomes  atrophic.  Ophthalmoscopic  examination  may 
be  negative,  although  usually  changes  can  be  noted  on  the 
retina  or  papilla.  There  is  no  treatment  of  value.  Cases 
due  to  poisons  may  recover. 


CHAPTER   IX. 
DISEASES  OF  THE  GLOBE  AND  ORBIT. 

INJURIES  to  the  eyeball  are  very  common.  They  occur 
as  wounds,  lacerations  and  contusions.  Sometimes  the 
eyeball  is  ruptured.  Diseases  involving  the  globe  and 
orbit  are  also  frequent.  The  following  are  the  most  impor- 
tant: (a)  Panophthalmitis,  (b)  glaucoma,  (c)  hydrophthal- 
mus,  (d)  exophthalmus,  (e)  luxation  of  the  eyeball,  (/) 
enophthalmus,  (g)  strabismus,  (h)  nystagmus,  (i)  parasites, 
0)  fracture  of  the  orbit,  (k)  inflammation  of  the  orbit,  (I) 
tumors  of  the  orbit. 

PANOPHTHALMITIS . 

Definition.— An  inflammation  of  the  entire  eyeball.  It  is 
usually  due  to  injury  with  infection,  or  may  develop  during 
the  course  of  infectious  diseases,  the  infection  being  carried 
to  the  eye  by  the  blood  or  lymph. 

Symptoms.— The  initial  symptoms  will  vary,  depending 
upon  whether  the  infection  enters  through  wounds  (exo- 
genetic)  or  is  carried  by  the  blood  or  lymph  (endogenic). 
When  panophthalmitis  begins  in  the  posterior  part  of  the 
eye  it  may  escape  attention  until  the  anterior  portion  is 
involved.  In  cases  of  exogenetic  origin  usually  a  wound 
through  the  cornea  or  sclera  is  found  out  of  which  pus 
discharges.  In  endogenic  infection  a  general  congestion  of 
the  eyeball  is  an  early  symptom.  As  the  disease  progresses 
perforation  usually  through  the  cornea  with  prolapsus  of  the 
iris  and  sometimes  the  lens  follows.  As  a  rule,  the  eyeball 
is  destroyed. 

Diagnosis.-  Panophthalmitis  should  be  differentiated  from 
phleginonous  conjunctivitis  and  inflammation  of  other 


GLAUCOMA  549 

parts  of  the  eye.  These  sometimes  present  symptoms  con- 
fusingly  like  it.  The  eye  should  be  carefully  examined  to 
avoid  error  in  this  regard.  Should  a  perforating  wound  be 
found  the  diagnosis  is  simplified. 

Prognosis.  — Unfavorable.  Almost  every  case  leads  to 
destruction  of  the  eyeball. 

Treatment.— An  effort  should  be  made  to  arrest  the  spread 
of  the  infection.  Obviously  as  the  deeper  structures  are 
involved  this  is  difficult  to  accomplish.  The  eye  should 
be  flushed  with  warm  antiseptic  solutions  (boric  acid,  2  per 
cent.;  ichthyol,  3  per  cent).  Subconjunctival  injections  of 
1-2  c.c.  of  a  solution  of  cyanide  of  mercury  (0.5  per  cent.) 
are  recommended.  Suppurating  wounds  should  be  drained 
and  flushed  out.  Usually  enucleation  of  the  eyeball  becomes 
necessary. 

GLAUCOMA. 

Definition.— A  term  applied  to  a  number  of  diseases  of 
the  eye  marked  by  intense  intra-ocular  tension,  atrophy 
of  the  papilla  and  blindness.  It  is  rare  in  animals.  It 
is  supposed  to  be  due  to  some  disturbance  in  the  lymph 
or  blood  circulation  of  the  eyeball  which  may  be  congenital 
or  acquired. 

Symptoms.  —  Glaucoma  develops  gradually  without  signs 
of  inflammation  and  with  little  evidence  of  pain.  The  early 
stages  are  often  overlooked.  As  the  disease  progresses  the 
pupil  dilates  and  a  marked  hardness  of  the  eyeball  develops 
due  to  increased  intra-ocular  pressure.  The  cornea  may  be 
clear  or  cloudy.  With  the  ophthalmoscope  the  optic  nerve 
appears  cupped.  The  vision  is  gradually  destroyed.  In 
some  cases  (inflammatory  glaucoma)  acute  inflammatory 
symptoms  suddenly  develop. 

Prognosis.  — Bad. 

Treatment.— Eserin  or  pilocarpin  should  be  tried;  if 
unsuccessful  relieve  the  intra-ocular  pressure  by  paracentesis 
of  the  anterior  chamber  of  the  eye.  The  results  are  usually 
unsatisfactorv. 


550  DISEASES  OF  THE  GLOBE  AND  ORBIT 

HYDROPHTH  ALMUS . 

Definition.— An  enlargement  of  the  eyeball  in  all  its  dimen- 
sions. It  is  common  in  pups  and  kittens.  Hydrophthalmus 
develops  slowly,  the  eyeball  enlarging,  the  curvature  of 
the  cornea  becoming  weaker,  the  pupil  dilated,  intraocular 
pressure  increased,  and  the  papilla  cupped.  The  condition 
is  usually  congenital. 

Treatment.— Eserin  and  pilocarpin  are  recommended,  but 
they  do  little  good.  Paracentesis  of  the  anterior  chamber  will 
relieve  intraocular  pressure  as  in  glaucoma.  Iridectomy  may 
be  tried. 

EXOPHTH  ALMUS. 

Definition.— An  abnormal  protrusion  of  the  eyeball.  It 
should  not  be  confused  with  normally  prominent  eyeballs  of 
some  breeds  of  dogs. 

Etiology. — Fracture  of  the  orbital  arch,  the  displaced  bones 
forcing  the  eyeball  outward;  edema,  abscess  or  hematoma 
in  the  postbulbar  tissue;  retrobulbary  cellulitis;  intra-orbital 
tumors;  tuberculous  growths  in  the  orbit.  Exophthalmus  is 
a  prominent  symptom  of  exophthalmic  goiter  in  dogs. 

Symptoms.  — One  or  both  eyes  appear  unduly  prominent. 
As  the  eyelids  do  not  entirely  cover  the  eye  the  surface  of 
the  cornea  becomes  dry  and  ulcerated. 

Prognosis.— The  prognosis  should  be  guarded. 

Treatment.— Treatment  is  only  successful  when  the  cause 
can  be  removed.  Tumors  should  be  operated,  enlarged 
thyroids  removed  and  the  affected  eyeball  protected. 

LUXATION  OF  THE  EYEBALL. 

Common  in  the  dog  and  cat.  Dogs  with  prominent 
eyes  are  predisposed.  It  results  from  injury,  fighting, 
becoming  caught  in  doors,  etc. 

Prognosis. — The  prognosis  will  depend  upon  how  long 
the  eye  has  been  prolapsed,  the  degree  of  injury  to  the  optic 
nerve  and  to  the  eyeball. 

Treatment.— The  patient  should  be  anesthetized  and  the 
prolapsed  eye  flushed  with  a  warm  antiseptic  solution 


ENOPHTHALMUS  551 

(boric  acid,  2  per  cent.).  Try  replacement  by  picking 
up  the  eyelids,  retracting  them  as  much  as  possible,  at 
the  same  time  gently  but  firmly  pressing  the  eyeball  back 
into  its  socket.  It  may  be  necessary  to  enlarge  the  palpe- 
bral  slit  by  cutting  the  outer  canthus.  After  replacement 
two  or  three  stitches  will  retain  the  eyeball  in  position. 
The  after-treatment  consists  in  fomenting  the  eye  with 
warm  water  and  keeping  it  lubricated  with  dilute  glycerin 
or  liquid  vaselin.  Should  panophthalmitis  or  hydrophthal- 
mitis  develop,  or  the  luxation  reappear,  enucleation  of  the 
eyeball  should  be  practised.  The  operation  is  as  follows: 
The  patient  should  be  given  a  general  anesthetic  and  the 
eyeball  thoroughly  washed  with  an  antiseptic.  The  lids 
are  held  apart  by  a  retractor,  or  with  dressing  forceps 
held  by  an  assistant.  Make  an  incision  through  the  con- 
junctiva at  the  corneal  margin,  dissect  back  to  the  muscles, 
cutting  them  off  close  to  their  attachment  to  the  eyeball. 
Keep  as  close  to  the  eyeball  as  possible.  When  all  of  the 
muscles  have  been  cut  away  pull  the  eyeball  downward  and 
excise  the  optic  nerve.  Control  hemorrhage,  pack  the 
socket  with  sterile  gauze,  or  iodoform  gauze,  put  retaining 
sutures  in  the  lids,  and  cover  the  whole  with  an  antiseptic 
pack  held  in  place  with  a  head  bandage.  In  twenty-four 
hours  remove  the  pack  and  treat  with  antiseptic  dusting 
powder.  Healing  is  usually  prompt. 


ENOPHTHALMUS. 

Definition.— An  abnormal  sinking  of  the  eyeball  into  the 
orbit.  It  is  rare  in  animals. 

Etiology.— It  may  be  congenital.  Most  cases,  however, 
are  acquired  and  due  to  an  atrophy  of  the  retrobulbar  fat 
cushion,  general  emaciation,  spasms  of  the  muscles  of  the 
eye. 

Symptoms.— The  eyeball  appears  retracted  intp  its  socket. 
It  should  be  distinguished  from  normal  eyes  which  are 
unusually  small.  The  general  condition  of  the  patient 
suffices  for  differentiation. 


552  DISEASES  OF   THE  GLOBE  AND  ORBIT 

Prognosis. —Depends  upon  the  cause. 
Treatment.— Determine   the   cause   and   eliminate   it   by 
proper  treatment. 

STRABISMUS. 

Definition.— A  deviation  of  one  of  the  eyes  from  its  normal 
direction  so  that  the  visual  axes  cannot  be  focussed  simul- 
taneously on  the  same  objective  point. 

Etiology.— It  may  be  due  to  a  mechanical  interference 
with  the  movement  and  position  of  the  eyeball,  paralysis  of 
the  muscles  of  the  eye,  intracranial  paralysis,  spasms  of  the 
eye  muscles,  cerebral  hemorrhage,  and  poisoning. 

Diagnosis.— The  diagnosis  is  not  difficult.  One  eye  will 
be  turned  inward  or  outward  while  the  fellow  one  is  directed 
straight  ahead. 

Treatment.— A  palliative  treatment  consists  in  applying 
a  counterirritant  to  the  region  of  the  orbit  and  administering 
internally  small  doses  of  iodid  of  potash.  A  radical  treat- 
ment is  to  perform  a  tenotomy,  severing  one  of  the  tendons 
of  the  eye  muscle  at  its  insertion  into  the  sclera.  The 
particular  tendon  to  be  divided  is  determined  by  the  indi- 
vidual case.  If  the  strabismus  is  convergent  the  internal 
rectus  is  cut;  if  divergent,  the  external.  The  operation  is 
briefly  as  follows:  Give  a  general  anesthetic.  Flush  the 
eye  with  antiseptics  and  follow  by  a  solution  of  codrenin  to 
control  the  hemorrhage.  Cut  through  the  conjunctiva  and 
carefully  dissect  down  to  the  tendon  which  grasp  with  a 
blunt  hook,  pull  forward  and  cut  oft'  with  a  scissors.  Unless 
the  tendon  is  entirely  severed  the  results  will  not  be  satis- 
factory. The  wound  in  the  conjunctiva  may  be  left  open. 
Flush  out  daily  with  antiseptic  solution. 

NYSTAGMUS. 

Definition.— A  continuous  rolling  movement  of  the  eye- 
ball. It  occurs  occasionally  in  dogs.  It  very  often  accom- 
panies epilepsy,  convulsions,  parasitic  invasion  of  the  ear, 
catarrh  of  the  ear  and  sometimes  accompanies  chloroform 
narcosis. 


TUMORS  OF  THE  OK  BIT  553 

Treatment.— No  treatment  beyond  rectifying  the  primary 
condition  of  which  it  is  a  symptom  is  recommended. 

PARASITES  OF  THE  EYE. 

Lice  (pediculi)  are  often  found  on  the  margins  of  the 
lids  and  on  the  skin  over  the  orbital  region.  Mange  mites 
also  invade  the  lids.  The  demodex  mite  may  enter  the 
Meibomian  glands,  conjunctiva  and  lacrimal  apparatus. 
The  Filaria  oculi  canini  is  occasionally  found,  and  spiroptera 
have  been  noted  in  the  eyes  of  birds. 

FRACTURE  OF  THE  ORBIT. 

Common  in  animals.  Careful  palpation  will  reveal 
crepitation. 

Treatment.— Treatment  should  follow  the  general  principles 
of  surgery.  Possible  injury  to  the  eyeball  demands  first 
consideration. 

INFLAMMATION  OF  THE  ORBIT. 

Usually  results  from  traumatism.  Due  to  the  abundance 
of  fat,  inflammation  of  the  orbit  spreads  rapidly  and  always 
endangers  the  optic  nerve  and  eyeball.  It  is  usually  diffi- 
cult to  obtain  proper  drainage  or  to  apply  antiseptics  to 
stop  the  progress  of  the  inflammation.  An  attempt  should 
be  made,  however,  to  secure  drainage  and  keep  the  parts 
clean. 

TUMORS  OF  THE  ORBIT. 

Infrequent.  Sarcomas,  carcinomas,  epitheliomas  and  oste- 
omas  have  been  noted  in  this  region.  It  is  usually  necessary 
to  enucleate  the  eyeball  in  order  to  remove  them.  Malig- 
nant tumors  are  apt  to  recur. 


PART  XIII. 
HERNIA. 


Definition.— The  term  hernia  is  applied  to  a  protrusion  of  a 
portion  of  the  abdominal  contents  through  a  normal  or  an 
abnormal  opening  in  the  abdominal  wall.  The  larger  number 
of  hernias  is  found  under  the  skin,  the  smaller  through  the 
diaphragm. 

Occurrence.— Hernia  is  very  frequent  in  the  dog  but  rather 
rare  in  other  small  animals. 

General  Remarks.— Hernia  may  consist  of  a  portion  of  the 
bowel  (enterocele),  a  section  of  the  omentum  (epiplocele),  or 
a  combination  of  both  (entero-epiplocele) ;  further,  a  portion 
of  the  uterus  may  be  protruded  (metrocele),  or  the  uterus  and 
its  ligamentous  attachments  (metro-mesometrocele) .  Some 
of  the  other  organs  are  occasionally  found  in  the  hernial  sac, 
such  as  the  liver  (hepatocele),  etc.  In  the  dog  it  is  possible 
to  find  almost  any  one  of  the  organs  of  the  abdominal  cavity 
present  in  the  hernial  sac.  The  number  and  forms  of  hernia 
are  quite  varied. 

The  following  parts  are  distinguished  in  a  hernia:  (a) 
Hernial  sac,  (b)  hernial  ring,  (c)  hernial  contents. 

(a)  The  hernial  sac  consists  of  the  skin,  subcutaneous 
cellular  tissues,  and  in  most  cases  the  peritoneum.  Some- 
times the  peritoneum  is  ruptured  and  when  this  occurs  the 
skin  and  subcutaneous  tissues  constitute  the  hernial  sac. 

(6)  The  hernial  ring  is  the  opening  through  which  the 
contents  pass  from  the  abdominal  cavity.  In  recent  hernias 
the  ring  is  made  up  of  the  margins  of  the  muscular  tissue,  and 
its  size  is  determined  by  the  rent  in  the  abdominal  wall.  In 


556  HERNIA 

old  cases  connective  tissue  elements  form  around  the  margins 
which  results  in  a  distinct,  firm  ring.  Palpation  of  a  hernia 
will  often  reveal  a  well  defined,  firm  enlargement  which  will 
serve  to  differentiate  recent  from  long  standing  cases. 

(c)  The  contents  of  a  hernia  are  quite  varied  and  will 
depend  somewhat  on  its  location.  In  most  cases  they  consist 
of  a  portion  of  bowel,  or  omentum,  or  both.  In  a  smaller 
number  a  portion  of  one  of  the  other  abdominal  organs  is 
present,  such  as  the  liver,  stomach,  spleen,  uterus  or  bladder. 
When  the  contents  fluctuate  on  palpation  it  may  be  due  to  the 
fluid  content  in  the  loop  of  bowel,  or  to  serum  which  accumu- 
lates from  a  venous  stagnation  of  the  imprisoned  contents. 

From  a  practical  standpoint  it  is  important  to  classify 
hernias  into:  (a)  Reducible,  and  (6)  irreducible. 

(a)  Reducible  hernias  are  those  in  which  the  contents  can 
be  readily  replaced  in  the  abdominal  cavity.  This  may  be 
done  by  manipulation,  or  is  often  accomplished  by  changing 
the  position  of  the  patient.  Such  hernias  present  certain 
characteristic  symptoms:  They  are  enlargements,  usually 
appearing  on  some  portion  of  the  abdominal  wall,  non-inflam- 
matory (usually),  easily  replaced  in  the  cavity,  and  the  ring 
readily  distinguished.  It  is  possible  in  many  cases  to 
determine  the  character  of  the  hernial  contents  by  palpation. 
Adhesions  will  take  place  in  some  cases  between  the  hernial 
sac  and  its  contents  which  will  interfere  with  complete  reduc- 
tion of  the  enlargement.  In  this  case,  as  soon  as  pressure  is 
removed  from  the  outside,  the  hernial  contents  will  again 
reappear  in  the  sac.  Practically  all  reducible  hernias  return 
unless  outside  pressure  is  maintained. 

(6)  Irreducible  hernias  are  those  which  cannot  be  returned 
by  manipulation  to  the  abdominal  cavity.  This  condition 
may  be  brought  about  by  adhesions  between  the  different 
parts  of  the  hernia,  by  swelling  around  the  hernial  ring,  or  by 
strangulation  with  subsequent  swelling  of  the  hernial  con- 
tents. When  a  loop  of  bowel  is  present  in  the  hernial  sac- 
strangulation  frequently  occurs  from  fecal  matter  accumu- 
lating and  distending  the  prolapsed  bowel.  It  is  very  impor- 
tant to  distinguish  between  strangulated  and  non-strangu- 
lated hernias.  The  differentiation  is  made  very  definitely 


UMBILICAL  HERNIA  557 

by  the  symptoms  shown  by  the  patient  and  the  local  examina- 
tion of  the  hernia.  Marked  symptoms  of  pain,  vomiting, 
and  local  inflammation  indicate  strangulation.  During  the 
secondary  stages  of  its  development  the  hernial  sac  becomes 
cold,  doughy,  and  non-sensitive  to  the  touch.  Fecal  fistulse 
(intestinal  fistulse)  occur  in  some  cases  from  a  sloughing  of 
a  portion  of  the  intestine. 

Forms.— The  following  are  the  most  common  hernias  found 
in  small  animals:  (a)  Umbilical,  (6)  ventral,  (c)  inguinal, 
(>/)  femoral,  (e)  diaphragmatic,  and  (/)  perineal. 

Umbilical  Hernia.— Etiology.— This  form  occurs  either 
congenitally  (usual)  or  a  short  time  after  birth.  The  hernial 
ring  is  formed  by  an  improper  closure  of  the  umbilicus,  or  the 
fibrous  organization  being  of  insufficient  strength  allowing 
the  abdominal  contents  to  pass  through.  Occasionally 
umbilical  hernia  occurs  accidentally  in  which  case  the  peri- 
toneum forms  the  inner  portion  of  the  hernial  sac. 

The  hernial  contents  may  consist  of  omentum,  small  or 
large  intestines,  or  both.  In  most  cases  in  puppies  the  sac 
contains  only  omentum. 

Symptoms.— The  presence  of  an  enlargement  at  the  umbili- 
cus which  may  be  soft  or  firm,  depending  on  the  contents  and 
local  conditions.  In  most  cases  the  contents  can  be  readily 
returned  to  the  abdominal  cavity.  Occasionally  adhesions 
are  present  which  prevent  this.  Strangulation  is  very  rare 
in  this  hernia. 

Treatment.  — In  puppies  many  cases  disappear  sponta- 
neously. Several  methods  of  procedure  in  treatment  have 
been  recommended: 

(a)  Pressure  bandage,  or  adhesive  tape,  applied  over  the 
part  for  a  few  days  has  proved  satisfactory  in  many  cases. 
This  method  keeps  the  contents  in  the  cavity,  allowing  time 
for  fibrous  -tissue  organization  to  close  the  ring. 

(6)  Operation. — When  adhesions  are  present  or  the  ring  is 
of  considerable  size,  it  is  advisable  to  perform  herniotomy. 
The  animal  is  anesthetized,  placed  in  a  dorsal  position  on  the 
table,  the  hair  removed  from  the  area  and  painted  with 
tincture  of  iodin.  An  incision  is  made  through  the  skin  of 
sufficient  length,  dissecting  the  hernial  contents  from  the 


558  HERNIA 

adjacent  tissues,  if  necessary,  carefully  so  as  to  avoid  injuring 
the  bowel.  Return  the  contents  to  the  abdominal  cavity. 
Remove  a  small  portion  of  the  hernial  ring  on  either  side 
making  a  fresh  wound  surface  to  facilitate  union  of  the 
parts.  Suture  the  wound  and  apply  after-treatment  as  in 
laparotomy  (see  Laparotomy). 

Ventral  Hernia.— Definition.— Ventral  hernia  is  a  term 
applied  to  a  subcutaneous  rupture  of  the  abdominal  muscles 
which  permits  the  abdominal  contents  to  pass  through. 
This  may  occur  at  any  point  in  the  abdominal  walls.  The 
hernial  sac  consists  of  the  peritoneum,  subcutaneous  tissue 
and  the  skin  in  the  majority  of  cases.  Sometimes  the  peri- 
toneum is  also  ruptured  allowing  the  contents  to  lie  immedi- 
ately under  the  skin. 

Etiology.— The  cause  of  ventral  hernia  is  usually  traumatic, 
or  intra-abdominal  pressure.  In  some  instances  when 
incomplete  union  of  the  abdominal  muscles  takes  place 
following  surgical  operations,  a  hernia  will  develop. 

Symptoms.— The  sudden  development  of  an  enlargement 
appearing  at  some  point  in  the  abdominal  wall.  The  size  of 
the  hernia  will  depend  upon  the  extent  of  the  rent  in  the 
abdominal  muscles.  Palpation  of  the  enlargement  will 
reveal  a  soft,  fluctuating  or  elastic  mass  which  can  be  reduced 
in  most  cases  except  when  strangulated.  When  reduction  is 
brought  about  the  opening  through  the  abdominal  muscles 
can  be  easily  determined  and  the  margins  of  the  hernial  ring 
felt.  Changing  the  position  of  the  patient  will  bring  about 
reduction  except  when  adhesions  are  present  or  the  parts 
strangulated.  Unless  the  hernia  is  very  recent  or  strangu- 
lated, there  will  be  no  inflammation  nor  pain  present  on 
manipulation.  It  is  necessary  to  differentiate  recent  hernia 
from  abscess.  This  can  be  done  by  careful  palpation  or  by 
explorative  operation.  Some  difficulty  will  be  experienced 
in  distinguishing  between  incarcerated  hernia  and  tumors. 
However,  the  consistency,  location  and  an  explorative  opera- 
tion if  necessary,  will  serve  to  make  the  distinction.  A 
strangulated  ventral  hernia  will  be  characterized  by  symp- 
toms of  inflammation,  doughy  consistency,  pain  on  palpation 
and  the  general  reaction  of  the  patient. 


VENTRAL  HERNIA  559 

Treatment.— After  the  examination  has  been  made  carefully 
to  determine  the  exact  conditions,  then  it  is  possible  to  decide 
on  the  method  of  procedure.  Treatment  in  ventral  hernia 
should  be  operative.  There  is  very  little  danger  providing 
the  usual  precautions  are  observed  in  opening  the  abdominal 
cavity. 

In  ventral  hernia  without  strangulation  or  incarceration 
the  operation  is  performed  as  follows:  The  animal  is  given  a 
laxative  and  fasted  for  twenty-four  hours.  The  field  of 
operation  is  shaved  and  an  antiseptic  pack  applied  for  the 
same  period.  The  animal  is  then  given  an  anesthetic, 
preferably  morphin,  placed  on  the  operating  table  in  an 
advantageous  position,  the  pack  removed  and  the  surface 
painted  with  tincture  of  iodin.  A  longitudinal  incision  is 
made  immediately  over  the  hernia  through  the  skin  and 
parallel  to  the  rent  in  the  abdominal  wall.  The  hernial 
contents  are  returned  to  the  abdominal  cavity.  It  is 
advisable  to  open  the  hernial  sac  in  order  to  determine  the 
condition  of  the  hernial  contents.  When  they  are  found 
normal  and  no  evidence  of  injury  to  the  structures  the  hernial 
sac  can  be  trimmed  off  with  the  scissors  and  the  rent  in  the 
abdominal  wall  sutured.  If  the  hernial  ring  indicates  fibrous 
tissue  formation,  it  is  advisable  to  trim  off  the  margins  with 
a  scissors  or  knife  to  produce  a  fresh  wound  surface  for 
approximation.  The  abdominal  wound  is  then  closed  as  in 
laparotomy  (see  Laparotomy). 

In  strangulated  ventral  hernia  treatment  should  be 
attempted  as  early  as  possible.  The  same  precautions  should 
be  observed  as  above  and  the  contents  examined  to  deter- 
mine the  cause  of  the  strangulation  and  the  condition  of  the 
contents  of  the  hernial  sac.  If  the  strangulation  is  produced 
by  a  constricted  ring  it  should  be  enlarged  with  a  probe- 
pointed  knife  sufficiently  to  allow  the  contents  to  be  returned 
to  the  abdominal  cavity.  The  wound  in  the  wall  is  closed 
in  the  usual  manner.  If  the  hernial  contents  have  been 
strangulated  and  retained  until  gangrenous  then  proper 
treatment  should  be  employed.  A  section  of  bowel  or  omen- 
turn  may  be  removed  without  difficulty  and  successfully 
when  properly  done.  Adhesions  when  present  should  be 


560  HERNIA 

carefully  broken  down  to  allow  the  contents  to  be  returned. 
Some  of  these  cases  may  present  special  problems,  and  there- 
fore a  careful  examination  of  the  contents  should  always  be 
made.  The  after-treatment  would  consist  of  keeping  an 
antiseptic  pack  in  contact  with  the  wound  for  a  few  days 
until  union  takes  place.  There  is  a  possibility  of  a  recurrence 
of  the  condition  if  union  of  the  abdominal  wall  is  incomplete. 
Reoperation  is  recommended  when  this  occurs. 

Inguinal  Hernia.— It  is  necessary  to  divide  this  form  of 
hernia  into  two  classes  on  account  of  the  anatomical  differ- 
ences in  the  female  and  male  animal:  1.  Inguinal  hernia  in 
the  female,  and  2.  inguinal  and  scrotal  hernia  in  the  male. 

1.  Inguinal  Hernia  in  the  "Female.— Etiology.— A.  very 
common  form  of  hernia.  The  inguinal  canal  in  the  female 
is  very  short  and  the  diameter  usually  greater  than  in  the 
male  animal.  During  pregnancy  considerable  strain  is 
thrown  upon  these  structures  resulting  in  a  hernia.  It  may 
result  also  from  increased  intra-abdominal  pressure,  from 
ascites,  distention  of  the  organs,  or  hypertrophy.  Congenital 
inguinal  hernia  in  the  female  has  been  observed.  • 

The  hernial  contents  consist  of  the  round  ligament  with 
peritoneum,  or  one  or  both  cornua  of  the  uterus.  In  a 
smaller  number  of  cases  other  abdominal  organs  may  be 
present. 

Symptoms.  —An  enlargement  appearing  just  posterior  to  the 
inguinal  mammae*  It  varies  in  size  from  a  small,  rounded 
mass  to  one  of  sufficient  proportions  to  reach  the  ground. 
The  consistency  of  the  hernia  will  depend  on  its  contents, 
sometimes  fluctuating,  at  other  times  firm.  When  the 
animal  is  pregnant  the  fetuses  may  be  palpated  in  the  hernial 
sac.  The  contents,  if  no  adhesions  are  present,  may  be 
easily  pushed  back  into  the  abdominal  cavity  and  the  hernial 
ring  distinctly  felt.  Placing  the  dog  in  a  dorsal  position 
with  the  hind  limbs  elevated  often  will  effect  replacement. 
Further,  there  is  no  symptom  of  inflammation  and  the  parts 
are  non-sensitive  on  palpation.  All  enlargements  appearing 
in  this  location  should  be  examined  from  the  standpoint  of 
hernia  as  it  is  not  always  possible  to  reduce  them  and  palpate 
the  ring. 


INGUINAL  AND  SCROTAL  HERNIA  IN  THE  MALE     56,1 

Treatment.  —Operation  is  advised  in  all  cases.  Herniotomy 
is  performed  in  the  following  manner:  The  animal  should  be 
properly  prepared  by  fasting  and  administration  of  a  laxative 
twenty-four  hours  in  advance.  The  operative  field  should  be 
shaved  and  disinfected.  Make  an  incision  longitudinally 
over  the  enlargement  through  the  skin  and  hernial  sac.  If 
no  adhesions  are  present  and  the  contents  capable  of  being 
replaced  this  should  be  done  at  once.  If  adhesions  are 
present  preventing  reduction  they  must  be  carefully  broken 
down  when  the  contents  will  return  easily.  Sometimes  the 
bladder  is  encountered  considerably  distended  with  urine. 
If  this  is  the  case,  introduce  a  trocar  and  draw  off  the  urine 
which  facilitates  replacement.  When  the  gravid  uterus  is 
found  in  the  sac  it  will  be  necessary  to  remove  the  fetuses 
in  the  usual  manner  and  return  the  cornua  to  the  abdominal 
cavity.  After  reduction  has  been  brought  about  the  hernial 
sac  should  be  ligated  as  close  to  the  cavity  as  possible  and 
removed,  pushing  the  stump  into  the  cavity.  Suture  the 
ring  by  inserting  the  sutures  close  together,  keeping  away 
from  the  pudic  veins.  The  extra  skin  which  will  be  present 
should  be  properly  trimmed  off  with  the  scissors  and  sutured. 
An  antiseptic  pack  is  applied,  renewed  daily,  and  kept  in 
position  until  union  is  complete.  The  external  sutures 
should  be  removed  when  the  wound  is  healed. 

2.  Inguinal  and  Scrotal  Hernia  in  the  Male.—  Etiology.— 
Inguinal  hernia  is  not  as  common  in  the  male  animal  although 
it  is  met  with  occasionally.  Dilatation  of  the  inguinal  canal 
from  any  cause  will  allow  the  intestines  or  omentum  to  pass 
through  carrying  a  portion  of  the  peritoneum  with  it  forming 
an  inguinal  hernia. 

Scrotal  hernia  is  far  more  common  in  the  male  animal. 
The  hernial  sac  is  formed  by  the  processus  vaginalis,  and  the 
•contents  consist  of  omentum  or  a  loop  of  bowel  protruding 
out  into  the  scrotum  in  contact  with  the  testicle.  The 
hernia  may  be  unilateral  or  bilateral. 

Symptoms.— Inguma.1  hernia  is  characterized  by  an  en- 
largement appearing  to  one  side  of  the  penis.     It  is  usually 
soft,  fluctuating,  and  reducible.     The  ring  can  be  palpated 
in  most  cases,     Occasionally  some  difficulty  in  diagnosis 
36 


562  HERNIA 

might  be  met  with  when  adhesions  are  present.  Explorative 
operation  would  be  recommended.  Scrotal  hernia  is  recog- 
nized as  an  elongated  enlargement  in  the  scrotum.  Palpa- 
tion will  usually  reveal  the  dilated  canal  and  the  contents 
can  be  easily  returned  to  the  abdominal  cavity.  Holding 
the  animal  up  by  the  hind  limbs  often  effects  replacement. 
Differentiation  should  be  made  from  other  scrotal  enlarge- 
ments. As  a  rule  no  particular  difficulty  will  be  encountered. 

Treatment. — In  inguinal  hernia  the  operation  would  be 
practically  the  same  as  in  the  female.  The  same  care  should 
be  exercised  to  avoid  complications. 

Scrotal  hernia  may  be  operated  in  two  wray s :  (a)  Inguinal 
operation,  and  (6)  scrotal  operation. 

(a)  Inguinal  Operation. — Prepare  the  dog  the  same  as  in 
the  female.  Make  an  incision  through  the  skin  over  the 
inguinal  canal  down  upon  the  internal  ring.  Open  the 
processus  vaginalis  and  pull  the  bowel  or  omentum  back  into 
the  abdominal  cavity.  Suture  the  internal  ring  but  allow 
sufficient  room  for  the  spermatic  cord  and  vessels.  A  certain 
amount  of  swelling  will  take  place  after  the  operation  which 
should  be  considered  when  applying  the  sutures.  This 
operation  is  especially  advised  when  the  male  is  to  be  kept  in 
the  stud. 

(6)  Scrotal  Operation.— This  operation  is  performed  by 
opening  the  scrotum,  removing  the  testicle,  returning  the 
omentum  or  bowel  to  the  abdominal  cavity,  and  suturing 
the  external  ring.  Retaining  sutures  should  be  placed  in  the 
scrotum  for  a  few  days  to  avoid  prolapsus  of  the  bowel  in 
case  the  other  sutures  tear  out. 

Femoral  Hernia. —This  form  of  hernia  is  not  common  in 
small  animals.  It  has  been  observed  in  a  few  instances.  It 
consists  in  a  portion  of  the  viscera,  in  most  cases  intestine 
with  peritoneum,  which  passes  through  the  femoral  canal  in 
close  proximity  to  the  femoral  vessels. 

Symptoms.— A  soft  enlargement  is  found  on  the  inner  part 
of  the  thigh  which  interferes  with  bringing  the  limb  forward 
producing  lameness.  Unless  strangulated  there  are  no 
inflammatory  symptoms.  Any  enlargement  in  this  location 
should  be  suspected  of  being  a  femoral  hernia. 


PEIUNEAL  HERNIA  503 

Treatment.  —  It  is  possible  to  reduce  femoral  hernia  by  the 
usual  hernia  operation  but  care  should  be  taken  to  avoid 
the  large  vessels  in  the  immediate  vicinity. 

Diaphragmatic  Hernia.— Definition.— A  hernia  taking  place 
through  the  diaphragm.  It  may  be  either  congenital  or 
acquired.  This  hernia  is  characterized  by  the  passage  of  a 
portion  of  the  abdominal  viscera  into  the  thoracic  cavity 
either  with  or  without  the  peritoneum. 

Etiology.— Most  cases  of  acquired  diaphragmatic  hernia 
occur  as  a  result  of  violence  in  which  the  diaphragm  ruptures 
allowing  abdominal  viscera  to  pass  through  the  rent.  Stran- 
gulation is  rare. 

Symptoms.— No  symptoms  are  observed  in  most  cases  of 
congenital  diaphragmatic  hernia.  In  the  acquired  form  the 
symptoms  come  on  suddenly  and  consist  of  severe  dyspnea, 
restlessness,  pain,  etc.  The  patient  as  a  rule  does  not  live 
but  a  short  time.  A  few  cases  have  been  observed  where  the 
patients  lived  for  several  months  showing  dyspnea  and 
marked  circulatory  disturbance.  A  diagnosis  is  in  most  cases 
difficult. 

Treatment.  — Xo  treatment  can  be  given. 

Perineal  Hernia.— Definition.— A  hernia  appearing  in  both 
males  and  females  and  characterized  by  an  enlargement  on 
one  or  both  sides  of  the  anus. 

Etiology.— The  perineal  tissue  is  easily  ruptured  or  torn 
allowing  some  of  the  abdominal  organs  or  omentum  to  pro- 
trude at  the  sides  of  the  rectum.  Perineal  hernia  is  often 
observed  in  trick  dogs  which  are  required  to  walk  a  great 
deal  on  their  hind  legs.  The  unnatural  position  and  the 
pressure  of  the  abdominal  organs  no  doubt  lead  to  rupture 
of  the  perineal  tissue.  It  may  also  result  from  strain  from 
coprostasis,  prostatic  enlargement,  -etc.  Strangulation  is 
rare  in  this  form  of  hernia.  In  some  cases  torsion  of  the 
bladder  accompanies  it. 

Symptoms.— This  hernia  is  recognized  as  an  enlargement 
appearing  at  one  or  both  sides  of  the  rectum.  The  majority 
of  cases  are  unilateral.  The  anus  is  pushed  to  one  side  and 
often  there  is  difficulty  in  defecation.  In  the  female  the 
enlargement  is  usually  slightly  lower  than  in  the  male. 


564  HERNIA 

The  consistency  of  the  hernia  will  depend  upon  the  con- 
tents. Perineal  hernias  are  usually  soft,  easily  reduced  and 
the  hernial  ring  readily  palpated.  Holding  the  patient  up  by 
the  hind  limbs  often  effects  reduction.  Should  the  bladder 
be  in  the  hernial  sac  the  patient  will  show  dysuria  and  the 
enlargement  feel  cystic.  A  positive  diagnosis  can  be  made  by 
puncturing  the  swelling  writh  a  trocar  and  obtaining  some  of 
the  contents.  A  differential  diagnosis  is  necessary  between 
the  hernia  and  enlargement  of  the  anal  pouches.  A  careful 
examination  will  reveal  the  difference  between  them. 

Treatment.— A  careful  consideration  of  the  symptoms 
should  be  taken  into  account  in  order  to  determine  definitely 
the  conditions  so  that  proper  treatment  can  be  applied.  If 
the  bladder  is  in  the  hernial  sac  replacement  should  be 
brought  about  as  soon  as  possible.  This  may  be  done  by 
carefully  manipulating  the  parts,  or  if  this  fails  open  the 
hernial  sac,  empty  the  bladder  with  a  fine  trocar  and  push  it 
back  into  the  abdominal  cavity.  Insert  the  sutures  rather 
deep  in  the  tissues  in  order  to  effect  deep  adhesions. 

In  the  female,  if  the  uterus  is  in  the  hernial  sac,  ventro- 
fixation  is  recommended.  Many  cases,  when  of  ordinary 
size  and  no  particular  disturbance  present,  should  not  be 
treated.  Castration  is  recommended  when  enlarged  pros- 
tates are  present.  In  some  cases  it  may  be  necessary  to 
remove  the  glands. 

Other  hernias  have  been  observed  but  they  are  so  rare  that 
no  attempt  will  be  made  to  describe  them. 


PART  XIV. 
INFECTIOUS  DISEASES. 


CHAPTER  I. 
ACUTE  GENERAL  INFECTIOUS  DISEASES. 

DISTEMPER  OF  DOGS. 

Definition.— An  acute,  infectious,  communicable  disease 
which  in  most  cases  affects  young  dogs. 

Occurrence.— This  is  one  of  the  most  common  diseases 
affecting  dogs,  and  is  known  in  every  country  where  dogs 
are  found.  It  is  particularly  a  disease  of  young  animals, 
the  majority  of  dogs  contracting  it  at  some  time  during 
the  first  year  of  their  lives.  Whole  litters  of  puppies,  or 
all  the  animals  in  a  kennel  may  become  affected  at  one 
time.  It  occurs  in  districts  as  an  enzootic.  In  cities  it  is 
more  prevalent  than  in  the  open  country.  The  season  of 
the  year  has  some  influence  on  its  prevalency  and  distribu- 
tion, the  fall  and  winter  months  being  most  productive  of 
the  disease.  Highly  bred  animals  are  more  commonly 
affected  than  those  bred  by  natural  selection. 

Etiology. — There  seems  to  be  considerable  difference  of 
opinion  in  regard  to  the  exact  etiology  of  dog  distemper. 
Some  claim  it  to  be  produced  by  a  specific  microorganism 
(Bronchosepticus  canis,  Torrey,  Ferry,  McGowan),  while 
others  think  it  is  due  to  a  filtrable  virus.  In  each  case  evi- 
dence has  been  produced  which  seems  to  substantiate 
the  claim  made.  Two  distinctive  factors  are  recognized  from 
a  clinical  standpoint:  (a)  A  primary  infectious  agent  which 


.")<)(>         ACUTE  GENERAL  INFECTIOUS  DISEASES 

produces  the  marked  initial  symptoms  of  the  disease.  (6) 
Secondary  organisms  which  produce  many  varied  and  serious 
complicating  conditions.  A  large  number  of  organisms  have 
been  isolated  from  animals  affected  with  distemper,  but  so 
far  they  have  proved  to  be  simply  secondary  invaders. 

Natural  Infection.— Natural  infection  takes  place  in 
several  ways.  It  may  be  either  direct  or  indirect,  the 
animals  coming  into  immediate  contact  with  each  other, 
or  through  intermediary  agents,  the  virus  being  taken  into 
the  digestive  tract  with  the  food  or  drink.  There  are  a 
number  of  factors  which  tend  to  favor  the  development  of 
the  virus,  such  as  influence  of  any  kind  which  reduces  the 
general  resistance  of  the  animal,  in  the  way  of  poor  food, 
insufficient  food,  colds,  etc.,  or  various  diseased  conditions 
interfering  with  the  assimilation  of  food.  Puppies  with 
weak  constitutions  are  especially  susceptible.  The  develop- 
ment of  the  disease  is  ordinarily  in  animals  from  three 
months  to  one  year  of  age.  Older  animals  are  very  seldom 
att'ected  and  if  so  take  the  disease  in  a  mild  form.  This 
may  be  explained  by  the  immunity  the  dog  possesses  or  by 
its  having  had  the  disease  in  a  mild  form.  House  dogs 
which  have  been  pampered  and  petted,  or  those  of  the  finer 
breeds  are  more  susceptible,  and  usually  take  distemper  in 
a  more  severe  form. 

It  has  been  determined  quite  conclusively  that  the  specific 
virus  produces  an  acute  or  peracute  condition  with  a  high 
temperature  followed  in  a  few  days  by  secondary  changes 
due  to  other  bacteria  resulting  in  various  complications, 
such  as  occur  in  the  skin  (pustules),  respiratory  passages, 
digestive  tract,  nervous  system,  etc. 

Necropsy.— Owing  to  the  variety  of  forms  of  distemper 
in  dogs  the  lesions  found  on  examination  are  of  many  kinds, 
varying  with  the  complications  due  to  secondary  infection. 
In  peracute  and  acute  cases  there  will  be  effusions  of  fluid 
from  the  serous  membranes  particularly  in  the  pericardial 
sac,  the  thoracic  and  abdominal  cavities.  Small  hemor- 
rhages are  observed  in  some  of  the  organs  (heart,  liver 
and  kidneys).  In  most  cases  of  distemper  the  lungs  will  be 
affected,  either  as  a  capillary  bronchitis,  congestion  or 


DISTEMPER  OF  DOGS  567 

bronchopneumonia.  The  pleura  is  usually  congested  and 
sometimes  covered  with  fibrinous  deposits. 

The  intestinal  tract  shows  marked  changes,  in  most  cases 
a  catarrhal  inflammation,  which  may  be  primarily  in  the 
stomach,  or  involving  the  entire  tract.  The  glands  in  the 
mucosa  are  swollen.  Erosions  and  ulcerations  are  fre- 
quently noted  in  the  subacute  or  chronic  forms.  The 
lymph  glands  of  the  mesentery  are  enlarged  and  edematous. 
The  liver  is  usually  congested,  or  inflamed,  frequently  show- 
ing degenerative  changes.  The  kidneys  are  enlarged,  the 
capsule  easily  removed  and  the  cortex  markedly  changed. 

The  central  nervous  system  is  often  involved  and  there 
will  be  found  congestion  of  the  membranes  and  the  cortex 
of  the  brain.  Small  hemorrhages  will  be  observed  in  some 
cases.  Other  pathological  changes  of  a  minor  character 
are  noted,  such  as  conjunctivitis,  keratitis  and  more  rarely 
panophthalmitis.  Pustules  in  the  skin  are  common. 

Symptoms. — There  is  quite  a  variation  in  the  symptoma- 
tology depending  upon  the  form  which  the  disease  takes. 
The  most  prominent  manifestations  are  those  of  an  infectious 
catarrh,  involving  the  membranes  of  the  eye,  the  respiratory 
and  digestive  systems.  The  catarrhal  symptoms  are  often 
complicated  with  those  of  severe  disturbance  of  the  brain 
and  cord,  pustular  eruptions  on  the  skin,  and  very  frequently 
bronchopneumonia.  For  clearness  in  the  description  of 
the  symptoms  it  is  best  to  consider  them  under  the  following 
headings,  depending  upon  the  part  affected: 

1.  Initial  Symptoms. — The  period  of  incubation  is  usually 
from  three  to  five  days.  This  period  will  vary  consider- 
ably, depending  upon  various  factors.  Some  few  cases  have 
been  known  to  develop  the  disease  in  two  to  three  days, 
while  in  others  it  required  two  to  three  weeks.  The  peracute 
type  of  distemper  is  ushered  in  by  marked  constitutional 
disturbances,  such  as  great  depression,  fatigue,  total  loss  of 
appetite,  a  very  high  temperature  (106°-107°  F.)  which  in 
the  course  of  several  hours  drops  to  normal,  and  later  to  sub- 
normal. This  form  of  the  disease  takes  a  very  rapid  course, 
the  animal  soon  passing  into  a  comatose  state. 


568         ACUTE  GENERAL  INFECTIOUS  DISEASES 

The  acute  form  usually  begins  with  a  rather  high  tem- 
perature (103°-106°  F.)  and  remains  elevated  for  several 
days  or  weeks.  Some  cases  show  a  marked  variation  in 
temperature,  beginning  with  a  high  temperature  which  in 
a  few  days  drops  to  normal  or  in  some  cases  subnormal 
where  it  remains  until  either  recovery  or  death  takes  place. 
In  some  cases  due  to  complications  the  fever  is  remittent. 
The  owner  wrill  notice  in  the  inception  of  the  disease  a 
change  in  the  disposition  of  the  animal.  Instead  of  being 
lively  it  will  be  stupid,  does  not  answer  the  call  or  obey 
commands  given  it.  The  hair  coat  becomes  rough,  quickly 
loses  its  gloss  and  the  animal  in  general  shows  a  dejected 
appearance.  On  examination  of  the  nose,  it  will  be  found 
hot  and  dry;  the  mucosa  becoming  irritated  induces  rather 
violent  sneezing.  After  one  or  two  days  more  pronounced 
symptoms  make  their  appearance. 

2.  Symptoms  Shown  by  the  Eyes.— In  a  -large  number  of 
cases  conjunctivitis  is  a  prominent  symptom.  In  the 
early  stages  it  begins  as  a  serous  conjunctivitis,  which  soon 
becomes  purulent  from  secondary  infection.  The  discharge 
from  the  eyes  consists  of  a  thick  mucus,  or  whitish  or  yellow- 
ish pus.  This  discharge  is  usually  found  collecting  chiefly 
at  the  inner  canthus  of  the  eye,  soiling  the  edges  of  the 
eyelids,  or  from  the  exudate  drying,  crusts  form  causing  the 
eyelids  to  adhere.  Usually  in  a  few  days  lesions  and  ulcers 
appear  on  the  cornea  as  a  result  of  the  irritant  exudate,  the 
patient  rubbing  its  eyes  or  pawing  them  with  the  forefeet, 
or  by  the  swelling  which  interferes  with  local  nutrition. 
These  ulcers  are  usually  small,  pin-point,  funnel-shaped  and 
extend  downward  in  a  straight  direction;  their  base  usually 
covered  with  a  pus-like  material.  They  heal  by  a  prolifera- 
tion of  vessels  from  the  edges  of  the  cornea.  In  some  cases 
the  ulceration  leads  to  partial  perforation  of  the  cornea, 
with  a  protrusion  of  the  Descemet's  membrane,  prolapsus 
of  the  iris  (staphyloma).  The  resulting  cicatrization  causes 
permanent  white  spots  on  the  cornea  (leukoma).  In  other 
cases  the  entire  cornea  becomes  opaque  (parenchymatous 
keratitis)  which  gives  the  eyes  the  appearance  of  ground 
glass.  Rarely  does  the  entire  eyeball  become  inflamed 


DISTEMPER  OF  DOGS  569 

(panophthalmitis).     Opacity  of  the  cornea  in  a  number  of 
cases  remains  for  weeks  and  even  months. 

3.  Symptoms  Shoicn  by  the  Digestive  Tract. — Vomiting  is 
an  early  symptom  in  a  large  number  of  cases.     The  vomitus 
often  consists  of  particles  of  food,  frothy  mucus  stained 
with  bile  in  cases  where  the  vomiting  is  persistent.    The 
mucous  membrane  of  the  mouth  is  hot,,  dry  and  congested. 
The  animal   drinks  freely  indicating  the  involvement   of 
the  mucosa  of  the  stomach  and  bowels.     Constipation  is 
invariably  the  rule  during  the  early  stages  of  the  disease, 
followed  by  diarrhea  in  the  course  of  a  day  or  so.     The 
f eces  in  the  latter  case  are  very  fetid,  often  shiny,  frothy 
and  even  bloody  indicating  hemorrhagic  intestinal  catarrh. 
The  intensity  of  the  gastro-intestinal  symptoms  varies  from 
mild    catarrh    to    a    severe    hemorrhagic    gastro-enteritis. 
Symptoms  of  icterus  are  present  in  some  cases  due  to  the 
catarrhal  duodenitis  (catarrhal  icterus). 

4.  Symptoms  in  the  Respiratory  Tract. — During  the  early 
stages  of  the  disease  the  nose  becomes  dry  and  hot.    There 
is  nasal  discharge  which  is  at  first  serous  but  later  thicker 
and  mucopurulent  in  character.     During  the  early  stages 
there  is  much  sneezing  and  sniffling  due  to  the  attending 
rhinitis.     The  dog  shows  much  distress  and  makes  frequent 
attempts  to  clear  the  nasal  passages  by  sudden  expiratory 
efforts,  rubbing  the  nose  against  objects  and  clawing  at  the 
nasal  openings  with    the   forepawrs.     The  discharge  accu- 
mulates around  the  nasal  openings  in  the  form  of  crusts; 
when  these  are  removed  the  skin  and  mucosa  often  show 
excoriations.     In   severe   cases   the   discharge   is   often   so 
copious  that  the  nostrils  will  be  found  partially  or  completely 
occluded. 

Catarrh  of  the  larynx  is  nearly  always  associated  with 
this  condition  and  is  manifested  by  a  cough,  which  usually 
occurs  in  paroxysms;  it  is  at  first  dry  and  harsh,  and  later 
becomes  moist  and  considerable  mucus  is  coughed  up,  which 
is  immediately  swallowed  by  the  animal.  These  paroxysms 
of  coughing  frequently  end  in  gagging  and  vomiting.  The 
catarrhal  inflammation  spreads  quite  rapidly  to  the  trachea 
and  bronchi.  The  resulting  bronchitis  causes  a  cough,  which 


570         ACUTE  GENERAL  INFECTIOUS  DISEASES 

is  deep  and  explosive.  The  respirations  are  accelerated. 
Auscultation  reveals  coarse,  sharp  vesicular  murmurs,  and 
rhonchi.  As  the  inflammation  proceeds  it  involves  the 
bronchioli  (capillary  bronchitis)  which  produces  increased, 
labored  respirations.  At  this  stage  there  is  usually  a  feeble 
harassing  cough,  most  noticeable  when  the  dog  is  made  to 
move,  or  if  the  thorax  is  manipulated.  The  auscultatory 
sounds  become  increased,  and  there  will  be  noted  dry  or 
moist,  crackling,  or  fine  rales.  In  very  weak,  or  young 
dogs,  in  which  the  exudation  accumulates  in  the  bronchioli, 
it  is  very  sure  to  produce  a  bronchopneumonia  on  account 
of  the  secretions  being  drawn  into  the  alveoli.  The  result- 
ing pneumonia  will  be  recognized  by:  (a)  The  great  increase 
in  the  temperature;  (6)  the  excessive  dyspnea  (inflation  of 
cheeks  at  each  expiration) ;  (c)  the  sitting  posture  of  animals 
with  elbows  spread  apart  to  facilitate  respiration;  (d)  irregu- 
lar vesicular  murmur;  (e)  irregular  dulness  and  tympany  on 
percussion;  (/)  the  bronchial  breathing  which  wrill  be  audible. 
The  cough  at  this  stage  becomes  very  dull  and  weak.  The 
nasal  discharge  becomes  very  fetid,  and  often  has  a  greenish 
cast.  During  the  last  stages  as  the  heart  becomes  wreak, 
symptoms  of  edema  of  the  lungs  appear  in  the  form  of 
severe  dyspnea,  and  bubbling  rhonchi. 

o.  Symptoms  Shown  by  the  Nervous  System. —This  disease 
in  practically  all  cases  is  accompanied  by  some  nervous 
phenomena.  It  often  begins,  especially  in  weak  individuals, 
with  marked  dulness  and  depression.  These  symptoms 
may  be  all  that  the  animal  will  show.  However,  in  a  great 
many  cases,  the  nervous  symptoms  develop  early  in  the 
course  of  the  disease,  and  are  manifested  by  excitement, 
restlessness,  yelping,  cries,  even  simulating  some  of  the 
symptoms  of  furious  rabies.  In  many  instances  tremors 
of  muscles,  tonic  and  clonic  spasms,  which  mpy  involve 
certain  groups  of  muscles  or  the  entire  muscular  system 
are  observed.  Local  spasms  and  twitchings  of  the  muscles 
are  frequently  observed  involving  the  muscles  of  the  face, 
over  the  region  of  the  head  and  neck.  The  masseter  muscles 
are  frequently  affected,  resulting  in  chattering  teeth  and 
foaming  at  the  mouth.  Spasms  of  the  muscles  of  the  neck 


DISTEMPER  OF  DOGS  571 

and  limbs  cause  regular  or  irregular  movement  of  the  head 
or  limbs.  These  movements  may  be  present  constantly  or 
periodically.  Convulsive  contractions  of  certain  groups  of 
muscles  are  frequently  observed,  in  which  the  animal  at 
first  becomes  restless,  excited,  runs  aimlessly  about,  is  sud- 
denly seized  by  tonic  and  clonic  spasms,  the  head  and 
neck  usually  drawn  backward,  falls  down  as  if  from  epilepsy, 
barks,  cries  and  becomes  unconscious  with  relaxation  of 
the  sphincter  muscles.  In  some  cases  the  animal  will  die 
during  these  convulsions;  in  others  there  is  a  gradual  return 
to  consciousness  and  in  one  or  two  minutes  the  animal 
is  able  to  rise.  Some  cases  pass  into  a  long-continued  state 
of  coma.  These  convulsive  seizures  may  become  less  fre- 
quent, and  entirely  disappear;  or  they  may  terminate  in 
partial  or  complete  paralysis.  Paralysis  is  a  very  common 
sequel  to  this  disease.  It  very  rarely  begins  at  the  onset  of 
the  disease,  but  appears  in  most  cases  during  the  latter 
period.  The  paralysis  may  be  confined  to  certain  groups 
of  muscles,  in  fact  the  posterior  limbs  are  most  often  aft'ected. 
The  paralysis  of  the  sphincter  muscles  is  a  very  frequent 
sequel.  Some  cases  begin  with  a  paralysis  of  the  posterior 
limbs,  and  result  subsequently  in  complete  recovery,  while 
others  show  a  progressive  ascending  paralysis,  resulting  in 
death  from  general  paralysis.  Various  paralytic  compli- 
cations are  often  observed  following  the  nervous  form  of 
distemper,  such  as  deafness,  amaurosis,  hemiplegia  laryngis, 
aphasia,  loss  of  sense  of  smell,  hydrocephalus,  etc. 

o'.  Symptoms  Shown  by  the  Skin.  — In  a  large  number  of 
cases  there  will  be  noted  a  characteristic  pustular  exanthema. 
Small,  red  spots  appear  along  on  the  abdomen,  on  the  inner 
surface  of  the  thighs,  occasionally  on  the  skin  of  the  face, 
around  the  eyes  and  on  the  internal  surface  of  the  external 
ear.  In  twenty-four  to  thirty-six  hours  these  red  spots  are 
transformed  into  miliary  nodules,  each  surrounded  by  a 
red  ring.  These  nodules  change  very  rapidly  into  vesicles 
which  become  infected  to  form  pustules.  The  pustules  vary 
but  are  usually  the  size  of  a  pea.  They  dry  up  either  into 
a  yellow,  brown  crust,  or  rupture  and  leave  reddened,  moist 
places  to  become  covered  later  by  a  scab.  When  the 


572         ACUTE  GENERAL  INFECTIOUS  DISEASES 

pustular  eruption  becomes  extensive  the  body  gives  off  a 
peculiar,  offensive,  sweetish  odor.  Healing  of  the  pustules 
takes  place  usually  in  about  six  to  eight  days,  leaving  bright 
pigmented,  reddish  spots,  which  remain  for  several  weeks. 
In  some  cases  the  pustular  form  of  distemper  may  spread, 
the  pustules  become  confluent,  forming  a  scabby  eczema, 
which  may  be  localized  around  the  eyes,  over  the  abdomen, 
or  thighs,  or  it  may  be  general  over  the  entire  body.  Com- 
plications, such  as  septicemia  and  septicopyemia  develop 
occasionally  from  this  form  of  the  disease.  When  the 
pustular  eruption  forms  around  the  margin  of  the  lips,  it 
often  spreads  rapidly  to  the  mucosa  producing  a  severe 
gangrenous  stomatitis.  Involvement  of  the  external  ear 
in  the  form  of  an  otitis  is  observed  in  a  large  number  of 
cases.  This  is  characterized  by  a  thin  fluid  secretion,  which 
accumulates  on  the  surface  of  the  ear,  dries  and  forms  a 
yellowish-brown  crust  or  scales. 

7.  General  -Symptoms.— The  initial  high  temperature  is 
usually  followed  by  a  remittent  or  subnormal  temperature. 
Some  cases  do  not  show  much  abnormality  in  temperature. 
Normal  temperature  in  this  disease,  when  other  marked 
symptoms  are  present,  does  not  always  indicate  a  favorable 
termination.  As  the  disease  progresses  the  animal  becomes 
emaciated,  weak,  and  the  action  of  the  heart  is  more  or  less 
disturbed,  depending  upon  the  severity  of  the  case.  The 
mucous  membranes  are  pale,  the  patient  becomes  very 
weak,  staggers  or  retains  a  recumbent  position. 

Diagnosis.— During  the  early  stages  of  distemper  it  pre- 
sents some  difficulty.  It  becomes  necessary  to  decide 
whether  we  have  distemper  to  deal  with,  or  the  beginning 
of  some  other  condition,  such  as  catarrhal  inflammation  of 
the  eyes,  nose,  lungs,  stomach  or  bowels.  An  accurate 
diagnosis  cannot  always  be  made  during  the  early  stages  of 
the  disease.  Just  as  soon,  however,  as  there  appear  symp- 
toms of  general  depression,  high  temperature,  the  implica- 
tion of  several  organs,  especially  in  a  young  dog,  distemper 
should  be  suspected.  Should  skin  pustules  be  present  they 
will  assist  materially  in  making  the  diagnosis. 

In  catarrhal  inflammation  of  the  bowels  there  is  usually 


DISTEMPER  OF  DOGS  573 

very  little  rise  in  temperature,  and  catarrhal  symptoms  of 
the  eyes,  nose,  etc.,  fail.  The  symptoms  of  cerebral  irri- 
tation sometimes  found  in  distemper  make  it  necessary  to 
differentiate  it  from  rabies.  The  characteristic  aggressive 
tendency  of  animals  with  rabies,  the  change  in  the  'voice, 
the  facial  expression,  and  the  absence  of  catarrhal  symptoms 
usually  make  the  differentiation  easy.  The  eruption  on  the 
skin  might  be  confused  with  mange,  but  negative  results  on 
microscopic  examination  would  at  once  show  the  difference. 
There  should  be  but  little  difficulty  experienced  in  differ- 
entiating it  from  eczema  as  the  lesions  and  their  location 
differ  and  the  other  symptoms  of  distemper  usually  present. 
The  convulsions  occurring  in  the  nervous  form  of  distemper 
are  distinguished  from  those  of  epilepsy  by  the  acute  char- 
acter, occurring  at  frequent  intervals,  and  the  local  muscular 
twitchings,  which  occur  even  between  the  convulsive  attacks. 

Prognosis.— The  prognosis  is  not  favorable,  even  in  the 
milder  forms  of  the  disease.  Owing  to  the  variety  of  forms 
the  disease  assumes,  and  the  frequent  complications,  the 
mortality  is  high,  amounting  to  approximately  50  per  cent. 
The  prognosis  depends  to  a  certain  extent  upon  the  type  of 
the  disease,  and  whether  or  not  the  animal  is  strong  and 
vigorous.  The  purely  exanthematous  form  is  most  favor- 
able. If  the  disease  confines  itself  to  this  form  the  majority 
of  the  cases  will  completely  recover  in  two  to  three  weeks. 

The  catarrhal  forms,  involving  the  respiratory  or  digestive 
systems,  are  less  favorable  owing  to  serious  complications 
which  attend  them. 

The  highest  mortality  occurs  when  the  nervous  system 
is  involved.  When  severe  nervous  phenomena  are  present 
the  prognosis  is  bad,  only  5  to  10  per  cent,  recovering. 
Where  there  is  a  continuous,  high  temperature  the  prog- 
nosis is  not  favorable  as  there  is  danger  of  heart  compli- 
cations. A  rapid  fall  in  temperature  to  below  normal  is 
also  a  grave  sign;  in  most  cases  it  indicates  the  approach 
of  death. 

Treatment.— Dietetic.  —  It  is  very  essential  in  distemper  to 
supply  the  patient  with  easily  digested,  nourishing  food. 
Perhaps  the  best  food  is  raw  meat  chopped  fine,  or  scraped 


574         ACUTE  GENERAL  INFECTIOUS  DISEASES 

into  a  pulp.  Patients  will  be  tempted  by  this  food  when 
they  will  not  eat  anything  else.  In  cases  where  the  appe- 
tite is  lost,  and  in  order  to  maintain  the  animal's  strength, 
beef  broth  is  most  excellent.  This  may  be  given  with 
warm  •  milk,  or  milk  with  an  egg  beaten  up  in  it.  Other 
foodstuffs  may  be  given,  depending  upon  the  progress  of  the 
case,  and  the  needs  of  the  patient.  In  the  digestive  form 
of  the  disease  only  small  amounts  of  liquid  foods  should  be 
given  via  the  mouth.  Rectal  feeding  with  warm  milk  and 
meat  broth  is  recommended  in  these  cases. 

Hygienic.— The  animal  must  be  well  protected  from  expos- 
ure to  extremes  in  temperature,  or  cold  draughts  of  air. 
They  should  be  placed  in  a  clean,  moderately  warm  well- 
ventilated  room.  The  bedding  should  be  kept  clean  at  all 
times.  Supply  plenty  of  fresh  water. 

Medical.— Owing  to  the  various  complications  the  medical 
treatment  must  be  essentially  symptomatic.  During  the 
early  stages  of  the  disease  calomal  (0.075-0.10)  is  recom- 
mended as  a  purgative  and  bowel  disinfectant.  This  dose 
may  be  repeated  in  twenty-four  hours  if  necessary.  To 
overcome  the  general  depression,  which  is  an  early  symptom, 
nerve  stimulants,  alcohol,  aromatic  spirits  ammonia,  mix 
vomica  tincture  (0.4-0.7),  anyone  of  which  should  be  given 
well  diluted,  and  repeated  as  the  case  demands.  As  an 
abortive  treatment  subcutaneous  injections  of^trichlorid  of 
iodin  (3  or  4  times  daily,  2-4  c.c.  of  a  solution  of  1-1000) 
have  been  used  with  very  good  results.  This  treatment 
when  given  early  in  the  course  of  the  disease  has  a  very 
beneficial  effect  in  regulating  the  temperature.  The  patients 
seem  brighter,  and  the  catarrhal  symptoms  diminished. 
The  injections  should  be  made  at  different  points  owing  to 
the  danger  of  skin  necrosis.  Further  medical  treatment 
will  vary  depending  upon  the  part  affected. 

(a)  When  the  disease  involves  the  eyes,  they  should  be 
washed  with  an  antiseptic  once  or  twice  daily,  boric  acid 
(2  per  cent.),  creolin  (1.5  per  cent.),  to  prevent  undue 
injury  to  the  cornea  and  other  structures  from  the  infection. 
In  obstinate  cases  with  excessive  pus  formation  and  dis- 
charge, silver  nitrate  solution  (0.5  to  1  per  cent.)  has  been 
found  very  efficacious.  When  there  is  extensive  parenchy- 


DISTEMPER  OF  DOGS  575 

mat ous  keratitis  solution  of  stovain  (1  to  2  per  cent.)  is 
useful  to  prevent  irritation  and  subsequent  injury  to  the 
eyes  from  rubbing  them  against  objects,  or  with  the  paws. 
Opacities  of  the  cornea  when  of  some  standing  may  be 
treated  with  a  silver  nitrate  solution  (2  per  cent.),  followed 
by  a  normal  salt  solution  as  a  wash,  or  succus  cineraria 
maratima  compositus  (0.4-0.7)  dropped  into  the  eye 
daily.  This  latter  preparation  has  proved  to  be  of  great 
value  in  the  eye  complications  of  distemper. 

(6)  The  respiratory  system  should  be  treated  by  remov- 
ing the  secretions  from  the  nasal  openings,  spraying  the 
nasal  passages  with  creolin  (2  per  cent.),  or  silver  nitrate 
solution  (0.25  per  cent.).  Warm  vapors,  such  as  steam,  or 
solutions  containing  alkalies  (bicarbonate  of  sodium)  given 
as  inhalations  are  highly  recommended.  When  there  is  a 
painful,  dry,  harsh  cough  the  following  formula  is  very 
beneficial : 

If — Morphinii  sulphatis 0.15 

Aqua  amygdalae  amarte 12.00 

Aqua  dest 150.00 

Misce  et  fiat  solutio. 

Sig. — Give  teaspoonful  once  or  twice  daily. 

Iii  the  presence  of  profuse  secretions,  sedatives  are  contra- 
indicated.  Instead  ammonium  chlorid  (0.1-0.5)  is  given  as 
an  expectorant  twice  daily  to  dissolve  the  mucus  and  other 
secretions.  If  symptoms  of  pneumonia  are  present,  counter- 
irritation  to  the  thoracic  walls  with  oil  of  mustard  and 
glycerin  (1-20).  Heart  stimulants  are  also  advised.  (See 
Treatment  of  Bronchopneumonia.) 

(c)  The  digestive  complications  are  treated  according  to 
the  conditions  found.  If  the  animal  is  constipated  it  should 
be  relieved  by  the  administration  of  a  purgative;  if  severe 
diarrhea  is  present  the  irritating  bowel  contents  are  first 
removed  by  a  laxative  followed  by  astringents  and  sedatives. 
The  following  formula  will  be  found  beneficial  in  the  latter 
condition: 

If — Tinctune  opii 10.0 

Gummii  acacia? 8.0 

Aqua?  fceniculi 250.0 

Misce  et  fiat  solutio. 

Sig. — Give  teaspoonful  two  or  three  times  daily. 


57<>        ACUTE  GENERAL  INFECTIOUS  DISEASES 

As  a  bowel  disinfectant  use  small  doses  of  salol  (0.2-0.5) 
twice  daily.  If  vomiting  is  persistent  it  must  be  controlled 
with  cold  \vater  containing  soda  (2  per  cent.),  salicylate  of 
bismuth  (0.3),  or  in  extreme  cases  by  small  doses  of  opium 
(0.05-0.15). 

(d)  For  the  stimulation  of  the  digestion  small  doses  of 
hydrochloric  acid    (0.1-0.5)   diluted   in  water  and  pepsin 
(0.075-0.5)  is  the  best  treatment.     It  is  advisable  to  stimu- 
late the  mucosa  further  with  tincture  of  gentian  (0.05-0.9), 
or  tincture  of  nux  vomica  (0.4-0.7)  given  once  daily.     Fluid 
extract  of  echinacese  (0.5-1.0)  is  also  used. 

(e)  When  nervous  symptoms  are  present,  it  is  important 
that  they  be  controlled  by  anodynes  and  sedatives  (mor- 
phin  0.03-0.09,  or  sodium  or  potassium  bromid  1-150  in 
water)  given  in  teaspoonful  doses  four  to  six  times  daily. 
Some  cases,  when  spasms  and  convulsions  are  severe,  will 
require  maximum  doses  to  control  them.     When  paralysis  is 
present,  electricity  is  highly  recommended,  also  strychnin 
(0.001)    once  or   twice  daily.     Subcutaneous   injections  of 
veratrin  (0.01-0.05)  are  sometimes  used.  • 

(/)  The  temperature  in  this  disease  is  rarely  treated,  and 
only  in  exceptional  cases  where  a  very  high  temperature 
remains  for  several  days  and  threatens  to  become  dangerous 
to  the  heart,  would  it  be  advisable  to  use  antipyretics. 
Phenacetin,  acetanilid  (0.25-0.50)  may  be  used  for  this  purpose. 

(g)  In  the  skin  form,  when  pustules  are  present,  they 
should  be  opened,  and  washed  with  creolin  (2  per  cent.). 
For  the  exanthema  the  skin  should  be  washed  with  an  anti- 
septic soap  (germicidal,  or  far  soap),  dried,  and  a  drying 
powder  or  zinc  oxid  ointment  applied.  The  latter  is  prefer- 
able. 

Sera  and  Vaccines.— This  disease  has  been  treated  quite 
extensively  during  the  past  two  or  three  years  with  vaccines 
and  sera.  Good  results  have  been  obtained  by  their  use 
by  some,  others  have  reported  less  favorably.  The  great 
advantage  no  doubt  in  the  use  of  these  preparations  is  to 
control  the  secondary  infection  which  produces  the  com- 
plicating conditions.  Varying  degrees  of  immunity  have 
been  claimed  by  the  use  of  vaccines. 


DISTEMPER  OF  CATS  577 

Prevention.— Animals  with  distemper  should  be  isolated 
and  kept  from  healthy  young  dogs.  Thorough  disinfection 
of  all  utensils,  bedding,  rooms,  etc.,  should  be  attended  to 
promptly. 

Preventive  inoculation  has  proved  of  value  in  a  large 
number  of  cases  and  is  highly  recommended. 

DISTEMPER  OF  CATS. 

Definition.— An  acute  contagio-infectious  disease  found 
more  commonly  in  young  cats.  Older  animals  are  less  often 
affected,  probably  due  to  either  an  acquired  immunity  (hav- 
ing had  the  disease  in  a  mild  form)  or  to  a  greater  natural 
resistance  against  the  infection.  The  disease  in  cats  is  not 
nearly  so  common  as  in  dogs. 

Etiology.— According  to  the  best  information  obtainable 
it  is  produced  by  the  same  causes  as  canine  distemper. 

Pathology.— The  pathological  lesions  are  principally  those 
found  in  canine  distemper,  except  that  the  disease  seems 
to  be  confined  mainly  to  the  respiratory  and  digestive 
tracts.  -In  the  respiratory  form  there  is  an  inflammation 
involving  the  nasal  passages  (rhinitis),  larynx  (laryngitis), 
the  bronchi  and  bronchioli  (capillary  bronchitis),  and  the 
lungs  (bronchopneumonia) .  The  digestive  tract  shows 
catarrhal  inflammation.  The  mucosa  is  covered  with  a 
heavy  mucous  exudate  which  in  some  cases  is  mixed  with 
blood  (hernorrhagic  catarrhal  gastro-enteritis) .  Some  of  the 
other  organs  (kidneys,  liver  and  heart)  show  degenerative 
changes. 

Symptoms.— The  initial  symptoms  are  those  of  inappe- 
tence,  depression,  vomiting  in  some  cases  and  moderately 
high  temperature  (103°-104°  F.).  When  the  respiratory 
passages  are  primarily  affected  the  animal  will  sneeze  fre- 
quently, there  is  a  discharge  from  the  nose  which  is  at 
first  thin,  but  later  becomes  thicker  and  glutinous.  This 
will  collect  around  the  nasal  openings  and  in  some  cases 
occlude  them  completely. 

Conjunctivitis  is  a  very  prominent  symptom.  At  first 
the  discharge  is  serous,  but  later  it  becomes  mucopurulent. 
37 


578         ACUTE  GENERAL  INFECTIOUS  DISEASES 

The  cornea  often  presents  the  characteristic  changes  noted 
in  dog  distemper.  The  bowel  form  is  observed  frequently, 
and  is  characterized  by  vomiting,  abdominal  pain  and  later 
severe  diarrhea.  The  animal  becomes  emaciated,  there  is 
marked  weakness  and'  a  fall  i,n  temperature,  which  often 
becomes  subnormal.  Convulsions  and  other  nervous  phe- 
nomena are  not  commonly  observed. 

Diagnosis.— The  diagnosis  depends  upon  the  existence  of 
catarrhal  symptoms  involving  the  eyes  and  nose,  the  tem- 
perature and  the  rapid  emaciation  and  weakness.  A 
differential  diagnosis  should  be  made  from  hemorrhagic 
septicemia.  In  this  disease  no  catarrhal  symptoms  are 
present,  as  a  rule,  but  there  is  marked  gastro-enteritis,  and 
the  course  is  peracute.  The  mortality  in  hemorrhagic 
septicemia  is  much  higher. 

Prognosis.— The  prognosis  is  bad.  The  mortality,  how- 
ever, is  lower  in  cats  than  in  dogs.  The  catarrhal  form 
involving  the  eyes,  nasal  passages  and  lungs  is  more  favorable 
than  the  bowel  form. 

Treatment.— Hygienic.— The  animal  should  be  kept  in  a 
moderately  warm  place,  free  from  draughts  of  air.  The 
room  should  be  well  ventilated,  and  every  precaution  taken 
to  prevent  unnecessary  exposure. 

Dietetic.— The  appetite  can  be  tempted  by  offering  small 
amounts  of  fresh  lean  meat,  or  liver  at  frequent  intervals. 
Milk  should  be  allowed  in  small  quantities.-  In  case  the 
animal  refuses  food,  it  is  advisable  to  give  small  quantities 
of  beef  broth,  or  warm  milk  to  maintain  strength. 

Medical.— A  laxative  is  given  at  the  onset  of  the  disease 
(castor  oil  4.0-12.0,  or  sulphur  in  milk  1.0-2.0).  The  eyes 
should  be  cleansed  daily  with  boric  acid  solution  (2  per 
cent.)  to  control  the  blennorrhea.  The  nasal  passages  can  be 
cleansed  with  a  similar  antiseptic  solution.  Small  doses  of 
opium  (tincture  of  opium  0.10-0.15)  are  often  beneficial  in 
preventing  the  spread  of  the  inflammation  in  the  stomach 
and  bowels  and  to  control  the  diarrhea.  Sulphocarbolate 
tablets  are  to  be  recommended  as  a  bowel  disinfectant 
(0.1-0.2).  When  pneumonia  threatens  inhalations  of  warm 
medicated  solutions  are  valuable.  Atropin  sulphate  (0.003) 


TYPHUS  OF  DOGS  579 

is  useful  to  sustain  the  heart  action.  Good  care  and  nour- 
ishing food  plays  a  very  important  role  in  the  treatment  of 
cat  distemper. 

TYPHUS  OF  DOGS. 

Canine  Typhus.     Hemorrhagic  Castro-enteritis. 
Dog  Plague.    Black  Tongue. 

Definition.— An  acute,  infectious  disease  occurring  in  an 
epizootic  form,  characterized  by  a  severe  gastro-enteritis, 
stomatitis,  and  in  some  cases  severe  nervous  symptoms. 

Occurrence.— During  the  past  few  years  this  disease  has 
appeared  as  an  epizootic  in  various  sections  of  the  United 
States,  producing  extensive  losses,  particularly  in  old  dogs. 
In  some  districts  it  has  made  the  breeding  and  handling  of 
dogs  prohibitive.  The  disease  has  been  disseminated  by  dog 
shows,  and  follows  in  the  wake  of  such  exhibitions. 

Etiology.  — The  nature  of  the  disease  indicates  that  it  is 
produced  by  some  specific  infection.  I  p  to  the  present 
time  the  infectious  agent  has  not  been  isolated.  Experi- 
mental inoculations  with  various  organisms,  which  have 
been  isolated,  have  not  proved  that  any  of  them  are  con- 
stant in  reproducing  the  disease  in  healthy  animals.  In  a 
number  of  outbreaks  in  this  country,  old  dogs  were  as  com- 
monly affected  as  young.  Further,  dogs  which  have  had 
distemper  severely  come  down  with  this  disease  in  a  severe 
form.  The  breed,  or  sex  of  the  animal  seems  to  have  noth- 
ing to  do  with  its  susceptibility.  The  infectious  agent  is 
probably  taken  in  with  the  food  or  drink.  The  disease  is 
spread  by  cohabitation,  or  by  the  infection  being  carried 
by  intermediate  agents.  The  period  of  incubation  is  from 
three  to  five  days. 

Pathology.— The  autopsy  in  this  disease  presents  a  rather 
constant  picture.  The  digestive  tract  is  mainly  involved. 
The  mucosa  of  the  mouth  is  often  inflamed;  ulcers  are 
found  in  a  number  of  cases,  particularly  noticeable  along  the 
margin  of  gums.  In  some  cases  extensive  necrosis  of  the 
buccal  mucosa  is  found.  The  tongue  is  frequently  thick- 


580        ACUTE  GENERAL  INFECTIOUS  DISEASES 

ened,  swollen  and  dark  red  or  bluish  in  color.  In  the 
stomach  the  lesions  are  very  prominent,  and  consist  of  an 
intense  inflammatory  condition.  The  mucosa  is  dark  red, 
or  almost  black,  corrugated  and  at  the  apex  of  the  corru- 
gations the  membrane  is  eroded. 

Hemorrhages  take  place  in  the  membrane  and  give  it  a 
more  or  less  mottled  appearance.  Some  cases  present 
extensive  hemorrhages  over  the  entire  membrane.  The 
surface  of  the  mucosa  is  covered  by  a  mucus  of  a  dark 
brown,  or  chocolate  color,  which  can  be  readily  scraped 
off.  The  contents  of  the  stomach  have  a  peculiar  offensive 
odor.  The  intestines  show  similar  changes,  but  in  most 
cases  not_  so  extensive.  The  cecum  and  small  intestines 
show  the  most  prominent  lesions.  The  peritoneum  covering 
the  bowels  is  congested  and  the  mesenteric  lymph  glands  are 
enlarged.  The  spleen  is  often  much  enlarged  and  shows 
evidence  of  acute  inflammation.  The  liver  and  some  of 
the  other  organs  are  hyperemic.  The  lungs  in  most  cases 
do  not  show  much  on  examination.  They  are  usually 
slightly  congested,  and  edematous.  The  heart  is  pale  in 
color  and  very  friable.  The  brain  and  its  membranes  may 
be  markedly  hyperemic,  or  show  but  slight  change.  The 
lesions  found  on  autopsy  are  indicative  of  a  more  or  less 
intense  gastro-enteritis. 

Symptoms.— The  initial  symptom,  which  is  quite  constant, 
is  a  very  persistent  vomiting.  The  vomitus  at  first  con- 
sists of  food  particles;  later  mostly  mucus  mixed  with  blood 
and  bile.  The  attacks  of  vomiting  often  begin  without 
any  previous  indication  of  illness,  and  suddenly  become  very 
severe,  producing  in  a  short  time  marked  weakness  and 
prostration.  The  appetite  is  lost;  there  is  rapid  exhaustion 
and  staggering  gait.  The  progress  of  the  disease  is  quite 
rapid.  Frequently  in  one  to  three  days  it  has  reached  its 
characteristic  form.  Examination  of  the  mouth  reveals  more 
or  less  extensive  lesions  of  the  mucous  membrane.  Along 
the  margin  of  the  gums  will  be  noticed  degenerative  or 
necrotic  changes,  ulcers  and  at  the  margins  of  the  lips  there 
will  be  present  the  characteristic  chocolate-colored  discharge. 
The  tongue  will  be  affected;  it  is  sometimes  partially  or 


TYPHUS  OF  DOGS  581 

completely  paraly/ed,  swollen  and  of  darkbluish  color.  A 
very  unpleasant,  peculiar  odor  is  emitted  from  the  mouth. 
As  the  disease  progresses,  the  degenerative  and  necrotic 
processes  continue  until  in  many  cases  the  ulcers  become 
confluent,  forming  extensive  ulcerative  surfaces.  The  tongue 
usually  in  the  later  stages  is  dry,  chapped,  loses  its  sensitive- 
ness, and  becomes  necrotic  or  gangrenous.  Necrosis  of  the 
lip  is  observed  in  some  cases,  usually  most  prominent  at 
the  commissures  of  the  mouth.  Palpation  over  the  region 
of  the  stomach,  which  often  induces  vomiting,  produces 
marked  pain.  Manipulation  of  the  bowels  is  also  painful  in 
most  cases.  Constipation  is  present  during  the  early  period 
of  the  disease  to  be  followed  later  by  diarrhea.  The  dis- 
charges from  the  bowels  are  mixed  or  streaked  with  blood, 
and  emit  a  very  offensive  odor.  The  mucous  membrane  of 
the  rectum  is  inflamed  and  shows  degenerative  changes. 
The  conjunctiva  shows  similar  discoloration  to  that  of  the 
mouth  (brownish-red),  strongly  injected,  but  the  absence  of 
a  purulent  discharge.  The  temperature  does  not  rise,  as 
a  rule,  at  any  stage  of  the  disease.  With  the  appearance 
of  depression  and  coma  the  temperature  falls  rapidly  to 
subnormal,  the  rule  in  this  disease.  There  is  no  cough 
and  in  most  cases  no  indication  of  lung  involvement  until 
the  later  stages  of  the  disease,  when  in  some  cases  acute 
edema,  or  a  foreign  body  pneumonia  producing  dyspnea 
develops.  The  urinary  secretion  is  nearly  always  dimin- 
ished or  suppressed.  Nervous  symptoms  of  excitement  and 
convulsions  are  occasionally  observed,  but  in  most  cases 
somnolence,  lassitude  and  coma  are  characteristic.  Modi- 
fication of  these  symptoms  may  be  found,  depending  upon 
the  severity  of  the  condition. 

Diagnosis. —There  are  some  very  characteristic  symp- 
toms which  materially  assist  in  establishing  a  diagnosis— 
the  sudden  and  persistent  vomiting,  the  inappetence,  the 
presence  of  ulcerations  on  the  mucous  membranes  of  the 
mouth,  the  great  depression,  the  character  of  the  vomitus, 
the  characteristic  injection  of  the  conjunctiva,  and  the 
normal  or  subnormal  temperature.  A  differential  diagnosis 
must  be  made  from  canine  distemper.  In  canine  distemper 


5X2        ACUTE  GENERAL  INFECTIOUS  DISEASES 

there  are  invariably  present  the  characteristic  catarrhal 
symptoms  involving  the  eyes  and  nasal  passages.  The 
period  of  incubation  is  usually  longer  in  distemper,  five  to 
nine  days.  Further,  distemper  is  more  common  in  young 
animals,  and  the  course  of  the  disease  is  acute.  This  disease 
must  also  be  differentiated  from  ptomain  and  other  poison- 
ings. In  some  cases  this  is  quite  difficult,  owing  to  the 
close  similarity  of  the  symptoms,  gastro-enteritis  appearing 
in  both  conditions.  The  necrosis  of  the  membranes  and 
ulcers  are  absent  in  ptomain  poisoning,  and  in  the  majority 
of  mineral  poisonings.  The  development  of  the  disease  is 
different  from  ptomain,  or  other  poisonings.  Canine  typhus 
usually  appears  as  an  epizootic  which  would  assist  in  estab- 
lishing a  diagnosis.  Differentiation  between  this  disease  and 
ulcerative  stomatitis  should  present  no  great  difficulties.  The 
absence  of  the  general  depression,  vomiting  and  gastro- 
enteritis in  ulcerative  stomatitis  is  indicative.  Scorbutus 
develops  slowly,  and  is  attended  by  neither  vomiting  nor 
general  symptoms. 

Course.— The  average  duration  of  the  disease  is  four  to 
six  days;  in  milder  cases  often  twelve  to  fourteen  days.  A 
few  cases  run  a  much  more  rapid  course  followed  by  death  in 
one  to  three  days.  At  the  beginning  of  an  outbreak  it 
seems  to  run  a  more  rapid  course  than  later. 

Prognosis.— The  prognosis  is  unfavorable;  the  mortality 
from  50  to  75  per  cent.  Young  animals  suffer  less  severely 
than  older  ones.  When  the  disease  develops  gradually, 
indicating  low  virulence  of  the  infection,  or  high  resistance 
on  the  part  of  the  animal,  the  prognosis  is  more  favorable; 
on  the  other  hand  when  the  development  of  the  disease 
is  rapid  and  the  symptoms  prominent,  the  outlook  is  grave. 
In  some  cases  recovery  takes  place  quite  rapidly,  and  when 
this  does  occur  there  is  usually  no  complication,  and  even 
the  ulcerative  processes  disappear  completely. 

Treatment.—  Dietetic.— During  the  early  stages  of  the  dis- 
ease, no  food  should  be  given.  After  the  acute  symptoms 
have  begun  to  subside  and  the  animal  reaches  the  con- 
valescent stage,  nutritious  food  can  be  allowed.  Meat 
broth  would  be  most  applicable  as  the  sensitive  mucous 


1' I 'KITH A  HEMORRHAGICA  OF  DOGS  583 

membrane  of  the  stomach  would  not  retain  solid  food. 
Later  small  amounts  of  meat  chopped  fine  could  be  given. 
Should  it  be  impossible  for  the  animal  to  retain  food  in 
the  stomach,  rectal  feeding  is  advisable,  using  concentrated 
meat  broth  warmed  to  the  body  temperature.  This  should 
be  injected  high  up  in  the  rectum,  small  amounts  given  every 
three  or  four  hours. 

Medical. — At  the  onset  of  the  disease,  when  vomiting  is 
severe  and  persistent,  it  would  be  best  to  wash  the  stomach 
with  sodium  bicarbonate  solution  (2  per  cent.).  This  may 
be  repeated  in  ten  to  twelve  hours.  To  allay  vomiting, 
sedatives  (morphin  subcutaneously,  0.016-0.12),  or  small 
amounts  of  cold  water  at  frequent  intervals  are  useful. 
Hot  packs  applied  to  the  epigastrium  are  beneficial.  Rectal 
injections  of  warm  water,  or  even  washing  the  entire  ali- 
mentary tract  with  sodium  bicarbonate  solution  (2  per  cent.) 
when  diarrhea  is  present,  will  remove  irritating  material 
and  infection.  In  obstipation,  warm  rectal  infusions  may 
be  used  in  preference  to  laxatives  or  purgatives.  Ichthargan 
has  been  highly  recommended  for  typhus  in  the  following 
formula: 

F$ — lohthargan, 

Gummi  arabicae  aa 20.0 

AqucD  chloroformi 60.0 

Misce  et  fiat  mist. 

Sig. — Give  teaspoonful  every  three  or  four  hours. 

Stimulants  (atropin  sulphate,  0.075-0.15  subcutaneously) 
to  sustain  the  heart  action  and  to  overcome  the  general 
depression  would  be  advised.  The  mucous  membrane  of 
the  mouth  should  be  washed  at  least  twice  daily  with  boric 
acid  solution  (2  per  cent.);  potassium  permanganate  (0.25 
per  cent.),  or  therapogen  (2  per  cent.).  The  animal  should 
be  well  protected  in  a  quiet  place.  In  a  great  many  cases 
the  treatment  has  proved  unsatisfactory  owing  to  the  per- 
acute  course  it  often  assumes. 

PURPURA  HEMORRHAGICA  OF  DOGS. 

This  disease  has  been  observed  in  dogs,  but  as  it  is  very 
rare  it  will  not  be  described  here.  (See  other  works.) 


584         ACUTE  GENERAL  INFECTIOUS  DISEASES 


FOWL  CHOLERA. 

Cholera  Gallinarum.    Pasteur ellosis  Avium.    Fowl 
Typhoid. 

Definition.— This  is  an  acute  contagious  disease  of  fowls, 
usually  occurring  in  an  epizootic  form,  and  affecting  par- 
ticularly chickens,  geese,  pigeons,  ducks,  quail,  sparrows  and 
pheasants.  It  is  characterized  by  a  general  infection,  and 
the  prominent  symptom  of  diarrhea. 

Occurrence.— Fowl  cholera  is  found  in  most  sections  of 
the  United  States,  causing  extensive  losses  to  poultrymen. 
The  finer  breeds  of  fowls  seem  to  be  more  susceptible  to 
infection,  probably  because  of  exposure  to  the  disease  at 
poultry  shows  and  other  public  exhibitions.  It  occurs  as 
an  epizootic,  sometimes  destroying  entire  flocks.  The  losses 
are  serious  from  an  economic  standpoint.  The  monetary 
loss,  which  is  great  when  a  large  number  of  birds  die;  the 
loss  in  egg  production,  and  the  interference  with  breeding 
operations  make  fowl  cholera  a  formidable  disease.  The 
disease  often  spreads  over  a  large  area,  producing  enormous 
losses. 

Etiology.— It  is  produced  by  the  Bacillus  avisepticus  (bipo- 
laris).  This  bacillus  is  one  of  the  smallest  bipolar  organisms. 

Pathogenesis.  —  The  transmission  of  the  disease  from  one 
bird  to  another  is  very  easy.  Directly  inoculating  the 
blood  from  a  sick  fowl  to  a  healthy  one  by  scarifying  the 
skin  or  membranes,  produces  the  disease  in  practically 
every  attempt.  Subcutaneous  and  intramuscular  inocu- 
lations bring  similar  results.  Inoculations  with  the  infected 
blood  of  any  of  the  birds  into  other  species  will  produce 
the  disease.  Instillation  of  the  infection  into  the  con- 
junctival  sac  of  fowls  produces  the  disease.  Feeding 
infected  meat  to  other  fowls,  or  cultures  of  the  organism 
will  in  the  majority  of  cases  result  in  the  bird  coming  down 
with  the  disease.  Other  animals— guinea  pigs,  mice  and 
rats— are  susceptible  to  the  disease  by  inoculation  with 


FOWL  'CHOLERA  585 

the  infected  blood  or  with  cultures  of  the  organism.  Some 
of  the  domesticated  animals  are  susceptible  to  intravenous 
injections  of  highly  virulent  cultures  of  the  organism.  The 
disease  is  not  produced  in  dogs,  cats  or  hogs  from  eating  the 
infected  meat  of  fowls.  The  virulence  of  the  organism  may 
be  increased  by  repeatedly  passing  it  through  chickens, 
guinea  pigs,  pigeons  or  sparrows.  The  organism  may  be 
attenuated  by  subjecting  it  to  sunlight,  drying  and  exposure 
to  the  air.  The  attenuation  may  be  sufficient  to  prevent 
further  spread  of  the  disease. 

Natural  Infection.— Natural  infection  may  take  place  in 
numerous  ways:  (a)  The  droppings  of  fowls  contaminate 
the  feed  and  water  given  other  fowls  and  the  infection  is 
thus  introduced  immediately  into  the  digestive  tract. 

(6)  In  most  cases  the  flock  is  infected  through  newly 
acquired  cholera-sick  birds,  or  birds  returned  from  shows 
or  exhibitions  where  they  have  been  in  contact  with  the 
infection. 

(c)  Pigeons  and  sparrows  play  an  important  part  in  the 
dissemination  of  cholera,   by  carrying  the  infection  from 
flock  to  flock.    This  accounts  for  isolated  outbreaks  of  the 
disease  where  no  exchange  of  birds  has  taken  place. 

(d)  The  infection  is  frequently  carried  on  clothing,  shoes 
and  other  objects. 

(e)  It  may  •  be  spread  by  carelessness  in  disinfecting  cars 
in  which  cases  have  been  transported.    This  has  proved  to 
be  the  source  of  infection  in  a  number  of  instances. 

(/)  Eggs  have  been  the  carriers  of  the  infection  in  some 
few  cases  reported. 

The  infection  in  most  cases  is  taken  directly  in  the 
digestive  tract  with  the  food  or  drink.  The  bacilli  pene- 
trate the  mucous  membrane  and  enter  the  lymph  spaces  of 
the  walls  of  the  intestines.  They  are  soon  taken  into  the 
circulation  where  they  multiply  very  rapidly.  In  some 
cases  when  the  infection  is  introduced  into  wounds  it  is 
taken  into  the  circulation  more  promptly,  and  consequently 
the  course  of  the  disease  is  more  rapid.  Death  results  in 
these  cases  no  doubt  from  the  large  amount  of  toxins  formed. 


.~>X()         ACUTE  GENERAL  INFECTIOUS  DISEASES 

Pathology.  — The  most  pronounced   pathological   changes 
»are  found  in  the  intestines,  heart  and  lungs.     In  the  acute 
form  the  following  lesions  are  found: 

(a)  The   intestines   show   marked   pathological   changes. 
The    mucous    membrane    throughout    the    entire    tract    is 
highly   congested   and    covered   in   numerous   places   with 
darker    areas.     The    intestines     contain    a     thin,    watery, 
frothy,  mucopurulent  and  yellow  exudate  often  mixed  with 
blood  and  bile  giving  them  a  dark  greenish  tinge.     Defects 
in  the  mucosa  are  often  present,  the  apex  of  the  intestinal 
villi  are  often  eroded,  and  in  some  cases  croupous  exudate 
is  present,  in  others  ulceration.    All  of  these  changes  in 
the  mucosa  may  be  observed  in  the  same  case.    The  mucous 
membranes  of  the  pharynx,  crop,  colon  and  rectum  show  the 
most  pronounced   lesions.     The   mesenteric   lymph   glands 
are  nearly  always  enlarged,  edematous  and  show  numerous 
petechiae. 

(b)  The  heart  shows,  as  a  rule,  distinctive  changes.     It 
is  covered  with  small,  dark  red,  pin-point  dots,  and  the 
bloodvessels  congested.     The  epicardium  is  often  covered 
by   a   fine  fibrinous   membrane.     The  pericardial   fluid   is 
nearly   always   cloudy,    containing    some   fibrinous    flakes. 
In  the  peracute  form  of  the  disease  these  changes  are  not 
so  prominent. 

(c)  The  lungs  are  found  congested,  thickened,  dark  red 
in  color,  very  heavy  (hepatized);  the  milder  type  will  show 
congestion   and   edema.     In   the   subacute   form  fibrinous 
pleuritis    is    frequently   noted.     The   larynx,    trachea    and 
bronchi  show  congestion  and  reddening   (catarrh).     Some 
of  the  other  organs  (spleen,  liver,  kidneys)  show  parenchy- 
matous  degeneration.     In  the  subacute  and  chronic  cases 
the  lesions  are  caseous  foci  in  the  lungs,  liver,  on  the  mucosa 
of  the  intestine  and   occasionally  on  the  epi-  and  endo- 
cardium.    Fibrinous   pleuritis   is   frequent   in   the   chronic 
form.     The  joints  of  the  limbs  are  often  involved,  showing 
exudation  and  more  or  less  marked  arthritis.     The  mus- 
culature in  the  chronic  form  will  be  grayish  in  color  and 
flabby. 


FOWL  CHOLERA  587 

Symptoms.—  The  period  of  incubation  varies  somewhat, 
no  doubt  due  to  the  mode  and  virulency  of  the  infection. 
It  is  usually  one  to  four  days;  occasionally  longer,  four  to 
seven  days.  Fowl  cholera  is  characterized  by  its  sudden 
onset  and  the  rapidity  of  its  course.  When  it  first  appears 
in  a  flock,  birds  will  drop  dead  apoplectically  without  show- 
ing symptoms.  They  may  be  found  dead  beneath  the  roost, 
or  on  the  nest.  Some  of  them  when  attempting  to  walk  or 
fly  will  drop  suddenly  and  die  after  a  brief  struggle.  After 
the  disease  has  been  in  a  flock  for  a  few  days,  the  less  sus- 
ceptible will  show  some  marked  symptoms.  The  birds 
lose  their  appetite,  become  weak  and  greatly  depressed. 
The  wings  are  usually  pendent,  the  neck  curved  and  the 
head  pulled  downward.  The  entire  plumage  becomes  ruffled 
and  the  birds  walk  with  a  weak,  staggering  gait.  The 
temperature  is  elevated  2  to  4°  F.  above  normal.  Diarrhea, 
accompanied  by  intense  thirst,  becomes  a  prominent  symp- 
tom. The  droppings  are  at  first  of  a  yellowish-gray  color, 
later  becoming  very  thin,  watery,  fetid,  of  a  greenish  cast 
or  dark  green.  The  feathers  around  the  cloaca  become 
soiled  and  matted  with  the  bowel  discharge.  Marked 
dyspnea  sets  in,  the  bird  opening  and  closing  its  mouth 
during  respirations;  wheezing  and  rhonchi  are  frequently 
heard.  The  comb  and  wattles  are  dark  bluish  (cyanotic). 
The  bird  finally  becomes  very  weak,  staggers  about,  falls 
down,  and  dies  in  coma  or  convulsions.  In  the  chronic 
form  of  the  disease  the  course  is  much  longer.  The  bird 
grows  anemic,  emaciated  and  cachectic.  Frequently  the 
joints  are  enlarged;  the  joint  capsule  may  rupture  and  dis- 
charge a  seropurulent  material.  Death  results  from  exhaus- 
tion. The  course  in  this  form  may  extend  over  a  period  of 
several  weeks. 

Diagnosis.— There  are  a  few  conditions  in  birds  that 
might  be  confused  with  cholera,  as  the  symptoms  are  similar. 
An  accurate  diagnosis  is  only  possible  on  finding  the  typical 
bacilli.  However,  the  symptoms  and  pathological  findings 
should  assist  in  making  a  diagnosis.  A  differential  diagnosis 
must  be  made  from  ptomain  poisoning  which  is  very  com- 
mon in  birds,  and  which  frequently  kills  a  large  number  in 


">SS         ACUTE  GENERAL  INFECTIOUS  DISEASES 

a  flock.  The  postmortem  examination  and  the  micro- 
scopic findings  will  be  sufficient  to  make  the  distinction 
between  them.  Parasites  in  the  bowels  sometimes  pro- 
duce similar  symptoms,  particularly  Trichosoma  collare, 
but  an  examination  of  one  or  more  of  the  affected  birds 
would  make  a  clear  differentiation.  Chronic  cases  are  some- 
times mistaken  for  tuberculosis  and  arthritis  urica,  but  the 
autopsy  and  microscopic  examination  would  at  once  make 
clear  the  difference.  Inoculations  with  the  blood  into  healthy 
birds  may  be  made  to  assist  in  making  the  diagnosis. 

Prognosis. — The  mortality  is  80  to  95  per  cent.  Fre- 
quently the  entire  flock  will  die.  In  some  outbreaks  the 
disease  runs  a  milder  course,  the  virulence  of  the  infection 
not  being  high. 

Treatment. — Medical. — Treatment  consists  in  the  adminis- 
tration of  bowel  antiseptics  and  disinfectants.  The  course 
of  the  disease  is  usually  too  rapid  for  any  medical  treatment 
to  be  of  value.  It  is  advisable  to  administer  to  the  entire 
flock  a  solution  of  iron  sulphate  (1  per  cent.),  which  they 
should  be  allowed  to  drink  of  freely;  or  a  solution  of  tannic 
acid  (0.5  to  2  per  cent.),  which  may  be  administered  with 
a  medicine  dropper  (1.0-2.0)  to  each  bird  twice  daily.  Some 
have  claimed  excellent  results  with  sulphocarbolates  (0.2-0.6) 
once  daily.  Various  other  medicines  have  been  recommended 
but  none  has  proved  to  be  specific. 

Vaccines  and  Sera.— The  treatment  of  sick  fowls  with 
vaccines  and  sera  has  not  been  successful  to  date. 

An  immune  serum  has  been  made  which  produces  a 
passive  immunity  lasting  for  a  period  of  one  to  two  weeks. 
This  is  recommended  as  a  preventive  when  the  disease 
makes  its  appearance  in  a  flock,  or  when  a  flock  of  birds  is 
exposed  to  infection. 

Vaccines  (autogenic  and  polyvalent)  have  been  used. 
The  results  have  been  unsatisfactory  where  the  birds  were 
already  infected.  On  the  other  hand,  very  good  results 
have  been  reported  from  the  use  of  autogenic  and  polyva- 
lent vaccines  to  prevent  the  disease  in  the  healthy  birds  of 
an  infected  flock.  Vaccines  seem  to  establish  immunity  in 
healthy  flocks,  preventing  the  disease  or  reducing  the 


FOWL  PEST  589 

mortality.  More  experimentation,  however,  is  necessary 
before  definite  statements  can  be  made  regarding  the  value 
of  vaccines  and  sera  in  the  treatment  of  fowl  cholera. 

Prevention.— Preventive  treatment  is  by  far  the  most 
important.  In  applying  it  the  following  should  be  consid- 
ered : 

(a)  All  newly  acquired  birds  should  be  isolated  for  at 
least  ten  days  before  being  allowed  to  come  in  contact 
with  the  regular  flock. 

(b)  When  the  disease  makes  its  appearance  in  the  neigh- 
borhood, precautions  should  be  taken  in  regard  to  the  car- 
riers of  the  infection.    Administer  antiseptics.     (See  Medical 
Treatment.) 

(c)  When  the  disease  appears  in  the  flock,  radical  meas- 
ures must  be  taken  promptly.     All  healthy  birds  must  be 
removed    to    new,    uninfected    quarters.     The    sick    birds 
should  be  destroyed  at  once,  and  either  burned  or  buried 
in  lime.     All  litter  and  droppings  should  be  treated  in  a 
similar  manner.  Disinfect  the  houses,  coops,  ground  and  yards 
with  liquor  cresolis  compositus,  using  one  gallon  to  thirty 
gallons  of  water.     Use  a  spray  pump  so  that  the  disinfectant 
will  be  forced  to  the  ceiling,  walls  and  all  parts  of  the  build- 
ing.    The  buildings  and  coops  should  then  be  allowed  to 
stand  open  for  a  few  days  to  allow  the  air  to  come  in  contact 
with  all  parts  of  it.     It  would  be  advisable  to  start  with 
a  new  flock  in  the  new  quarters  after  a  few  weeks.     A 
second  disinfection  would  be  recommended  before  allowing 
birds  to  be  placed  in  the  buildings. 

FOWL  PEST. 

Fowl  Plague.     Pestus  Aviurn. 

Definition. —An  acute,  contagious,  infectious  disease  of 
fowls.  Very  similar  in  many  respects  to  chicken  cholera. 

Occurrence.— This  disease  has  been  reported  from  different 
sections  of  the  United  States,  occurring  in  the  form  of  an 
epizootic.  It  has  been  very  prevalent  during  the  past 
ten  years  in  some  of  the  European  countries  (Germany, 


590 

Belgium,  Italy  and  France).  There  is  no  doubt  but  that 
it  has  frequently  been  mistaken  for  fowl  cholera. 

Etiology.— This  disease  is  produced  by  an  ultramicroscopic 
virus.  The  exact  nature  of  this  virus  has  never  been  deter- 
mined. It  is  contained  in  the  blood,  the  droppings,  the 
exudate  found  in  the  serous  cavities,  the  bile  and  in  the 
nasal  discharges.  The  filtrate,  when  passed  through  porce- 
lain filters  and  injected  into  healthy  chickens  will  produce 
the  characteristic  symptoms  rather  constantly. 

Pathogenicity.— Practically  all  fowls  are  susceptible  to  the 
virus  which  is  most  commonly  found  in  chickens,  turkeys, 
sparrows  and  pheasants.  Water  fowls  and  pigeons  are  less 
susceptible  to  infection.  Mammalia  are  not  susceptible  to 
the  virus. 

Natural  Infection.- Cohabitation  of  birds  so  that  they 
come  in  contact  with  the  nasal  discharges  and  droppings 
from  the  sick  is  the  most  likely  way  in  which  infection  is 
spread  through  a  flock.  Ingestion  of  food  contaminated 
with  the  virus,  or  the  eating  of  infected  viscera,  or  blood, 
introduces  the  virus  immediately  into  the  digestive  tract 
where  it  develops  and  produces  the  disease.  Infection  takes 
place  no  doubt  in  some  cases  from  the  infection  entering 
the  tissues  through  lesions  in  the  skin  or  mucous  membranes. 
The  transmission  of  the  disease  may  be  brought  about  by 
the  virus  being  carried  through  intermediate  objects. 

Pathology.— The  lesions  found  on  autopsy  are  similar  in 
some  respects  to  those  found  in  fowl  cholera.  In  the  per- 
acute  cases  the  lesions  may  be  very  slight.  The  principal 
lesions  are  those  found  in  ordinary  septicemia,  especially 
hemorrhages  in  the  serous  membranes  (pleura,  peritoneum, 
epi-  and  endocardium),  and  in  the  mucous  membranes  of 
the  digestive  tract.  The  finding  of  a  fibrinous  exudate  on 
the  peritoneum  and  pleura  has  been  frequently  reported. 
Hyperemia  of  the  spleen,  liver  and  kidneys  is  usually  present. 
The  comb  and  wattles  are  dark  bluish  in  color  (cyanotic). 
Catarrhal  inflammation  of  the  conjunctiva  and  buccal  mem- 
brane, with  collections  of  frothy  mucus,  is  often  noted.  In 
the  digestive  tract  changes  occur  on  the  mucous  membrane 
such  as  hemorrhages,  collections  of  grayish-white,  or  yel- 


FOWL  PEST  591 

lowish-green  fecal  material.  Catarrhal  inflammation  of  the 
intestinal  mucosa,  in  varying  degrees  of  intensity,  is  found 
throughout  its  course.  The  lungs  are  but  slightly  involved 
in  the  majority  of  cases. 

Symptoms.— These  develop  suddenly  after  a  period  of 
incubation  of  three  to  five  days.  They  consist  chiefly  of 
depression,  marked  dulness,  plumage  becomes  rough,  comb 
and  wattles  bluish-red;  drowsiness,  coma,  paralysis.  The 
fowl  will  seek  dark  places,  sit  with  head  down  in  a  crouching 
attitude,  and  refuse  to  move  except  when  forced  to  do  so. 
They  will  show  a  staggering  gait,  and  as  the  disease  pro- 
gresses will  not  be  able  to  walk.  There  is  nearly  always  a 
profuse  discharge  from  the  eyes,  the  conjunctiva  inflamed 
and  swollen.  Collections  of  a  similar  secretion  are  found 
in  the  nasal  passages,  mouth  and  throat.  On  opening  the 
mouth  the  membrane  will  show  injection;  in  some  cases 
hemorrhages  and  a  thick  glutinous  collection  over  its  surface. 
The  bird  often  shakes  its  head  and  sneezes  frequently  to 
discharge  the  exudate  which  has  collected.  The  bowel  dis- 
charges may  be  normal  in  appearance,  or  thin,  watery  and 
have  a  greenish  tinge.  Sometimes  hemorrhages  occur  in  the 
bowels  which  give  the  feces  a  red  or  brown  color. 

As  the  disease  progresses  the  bird  becomes  much  weaker, 
shows  marked  dyspnea  and  dies  from  paralysis.  Some 
cases  show  spasms  and  convulsions  shortly  before  death. 

The  course  of  the  disease  is  usually  three  to  five  days. 
Subacute  cases  last  five  to  eight  days. 

Diagnosis.— There  is  always  some  difficulty  in  differen- 
tiating between  fowl  pest  and  fowl  cholera.  The  symptoms 
and  autopsy  are  so  similar  that  it  is  necessary  to  make  a 
microscopic  examination  to  determine  whether  or  not  the 
bacilli  of  fowl  cholera  are  present.  In  fowl  pest  no  organisms 
are  found  on  microscopic  examination,  nor  on  cultures. 

Differential  Diagnosis.— The  differential  diagnosis  will 
depend  upon:  (a)  Microscopic  findings;  (6)  the  infectio- 
contagious  character  of  the  disease  (to  distinguish  from 
ptomain  poisoning);  (c)  the  well-known  infectiousness  of 
cholera  virus  to  pigeons  which  are  not  susceptible  to  fowl 
pest. 


592         ACUTE  GENERAL  INFECTIOUS  DISEASES 

Prognosis.— As  most  cases  terminate  fatally,  the  prognosis 
is  bad. 

Treatment.— No  medical  treatment  is  known  that  has  any 
material  effect  in  controlling  this  disease  after  the  fowl  is 
once  infected.  Preventive  treatment  is  by  far  the  most 
important,  and  should  consist  of  radical  measures  of  iso- 
lation and  disinfection.  (See  Fowl  Cholera.) 


CHAPTER  II. 

ACUTE  INFECTIOUS  DISEASES  WITH   LOCALIZA- 
TION IN  CERTAIN  ORGANS. 

EPITHELIOSIS  INFECTIOSA  AVIUM. 

Contagious  Epithelioma.     Chicken-pox.     Diphtheria. 
Ronp.     Canker. 

Pre valency  and  Distribution  of  the  Disease.— The  disease 
affects  nearly  all  birds,  especially  chickens,  turkeys,  pea- 
fowls, pheasants,  guineas,  pigeons,  sparrows,  quail,  etc., 
but  is  not  so  frequently  observed  in  ducks,  geese  and  swans. 
The  malady  is  widely  distributed,  appearing  in  practically 
all  countries  where  birds  are  found  in  any  considerable 
numbers.  In  the  United  States  infectious  epitheliosis  is 
quite  prevalent,  especially  in  the  northern  states  during  the 
colder  months.  In  the  fall  when  the  cold,  damp  weather 
begins  outbreaks  occur  quite  commonly,  and  poultrymen 
often  refer  to  the  early  inception  of  the  disease  as  a  "cold." 
The  intensity  of  the  disease  usually  increases  until  the 
warm  weather  makes  its  appearance,  when  it  diminishes  and 
lies  dormant,  to  reappear  at  the  first  cool,  damp  weather  in 
the  fall  when  the  birds  are  more  closely  confined. 

Etiology.  -Evidence  obtained  by  experiments  indicates 
that  a  filtrable  virus  is  the  primary  causative  agent,  and 
that  the  more  or  less  severe  complicating  conditions  are 
induced  by  secondary  infection,  of  which  a  bacillus,  probably 
the  Bacillus  diphtheria1  columbarum  of  Loeffler,  seems  to  be 
the  most  constant. 

Pathogenesis.  —  Transmission  of  this  disease  is  not  very 

difficult.     Usually  about  70  per  cent,  of  healthy  birds  will 

show  symptoms  of  the  disease  after  associating  with  an 

affected  one  for  a  short  time.    Actual  contact  is  not  neces- 

38 


594  ACUTE  INFECTIOUS  DISEASES 

sary,  as  is  shown  by  the  spread  of  the  disease  at  poultry 
shows.  A  bird  with  mucous  membrane  lesions  may  trans- 
mit the  disease  to  a  susceptible  bird  in  the  cutaneous  form, 
and  vice  versa. 

Emulsions  of  scrapings  from  either  cutaneous  or  mucous 
membrane  lesions  injected  subcutaneously,  submucously  or 
applied  to  scarified  areas  on  the  skin,  would  in  some  cases 
produce  the  generalized  form  of  the  disease.  Similar  results 
were  produced  by  using  an  emulsion  of  a  twenty-four-hour 
agar  growth  of  cultures  taken  from  ,  lesions  and  injected 
subcutaneously. 

It  is  possible  at  times  by  scarifying  the  mucous  mem- 
brane of  apparently  healthy  birds  to  produce  at  the  point 
of  injury  local  lesions  not  unlike  those  of  this  disease,  but 
they  disappear  in  a  few  days  without  manifestation  of 
general  symptoms.  Incomplete  experiments  by  using  the 
blood  of  sick  birds  in  an  attempt  to  produce  the  disease 
gave  negative  results,  which  is  contrary  to  that  claimed  by 
a  few  other  investigators. 

Natural  Infection.— There  are  a  variety  of  ways  by  which 
natural  infection  takes  place.  Cohabitation  is  one  of  the 
most  common,  an  infected  bird  introducing  the  disease 
into  an  entire  flock.  The  exfoliated  membranes,  or  the 
exudate  given  off  while  sneezing  or  coughing,  act  as  inter- 
mediary carriers  to  the  healthy  birds.  The  infection  in  this 
way  will  find  lodgment  on  the  skin  where  there  are  slight 
abrasions,  or  on  the  mucosa  of  the  eyes  or  mouth,  where 
it  develops  either  to  form  the  pox  lesions  or  the  various 
other  forms  found  on  the  mucous  membranes. 

It  is  quite  possible  to  have  the  disease  develop  in  the 
eyes  by  the  infection  gaining  entrance,  and  the  bird  irri- 
tating the  skin  and  conjunctiva  by  rubbing  them  against 
objects  or  by  scratching  them  with  their  feet.  The  disease 
is  frequently  spread  by  food  or  drink  which  is  contaminated 
with  infective  material. 

A  very  common  source  of  the  disease  is  the  poultry  show 
where  infected  birds  are  exhibited,  and  conditions  exist 
favorable  to  reduce  the  bird's  resistance.  It  very  fre- 
quently happens  that  on  the  return  of  birds  from  the  show 


EPITHELIOSIS  INFECTIOSA  AVJUM  595 

the  disease  develops  in  the  course  of  a  week  or  ten  days. 
Sparrows  and  pigeons  are  common  carriers,  often  trans- 
porting the  infection  great  distances.  This  is  a  very  impor- 
tant method  of  transmission  often  overlooked.  The  disease 
has  been  observed  in  sparrows  in  a  number  of  cases  and 
exhibiting  in  them  the  same  characteristics  as  in  other 
birds.  Sparrows  and  pigeons  come  in  direct  contact  with 
poultry  at  feeding  time  and  thus  infect  them.  It  is  some- 
times spread  by  such  intermediary  agents  as  infected  coops, 
clothing,  etc.  Young  birds  are  more  susceptible  to  the 
infection  than  older  ones.  Pigeons  and  chickens  seem  to 
be  far  more  susceptible  than  other  birds. 

It  has  been  observed  that  one  attack  of  the  disease  will 
produce  immunity  for  a  certain  period.  Either  the  skin 
form  or  involvement  of  the  mucous  membranes  confers 
equal  immunity  against  the  opposite  form. 

Pathology.— The  postmortem  findings  vary  with  the 
immediate  cause  of  death.  In  rare  cases  when  death  is 
due  to  suffocation  early  in  the  disease  only  the  acute  con- 
ditions are  noted.  The  body  appears  fairly  well  nourished, 
the  mucous  membranes  are  covered  with  a  thick  slimy 
mucus  which  may  occlude  the  upper  air  passages.  In  the 
larynx,  or  somewhere  along  the  trachea,  possibly  in  the 
larger  bronchi,  will  be  found  the  mass  of  dense,  tough, 
yellowish  material  obstructing  the  lumen. 

In  some  cases  when  both  eyes  are  involved  death  results 
from  starvation  early  in  the  disease.  The  body  is  emaciated. 
The  mucous  membranes  of  the  eyes,  and  often  of  the  mouth 
and  respiratory  passages  show  inflammation,  and  usually 
there  is  a  mass  of  this  same  yellow  material  in  the  con- 
junctival  sac  distorting  or  obscuring  the  eyes.  The  skin 
around  the  eyelids  may  also  be  involved. 

The  majority  of  the  fatal  cases  die  in  two  to  five  weeks. 
In  these  the  body  shows  all  the  symptoms  of  a  toxemia, 
emaciation  is  pronounced,  and  the  serous  membranes 
studded  with  petechise.  In  the  cutaneous  form  the  skin 
presents  all  the  symptoms  of  a  severe  inflammation,  each 
nodule  being  a  distinct  process.  Some  of  them  show  a 
similarity  to  tumor  formation,  especially  on  the  comb  where 


596  ACUTE  INFECTIOUS  DISEASES 

the  skin  is  thickest,  but  on  the  wattles  and  feathered  skin 
around  the  head  this  feature  is  less  pronounced.  Masses 
of  tough  yellow  material  often  distend  the  suborbital  fossae, 
accumulate  in  the  external  ear,  in  the  lung  substance  and 
along  the  digestive  tract. 

Symptoms.— The  disease  assumes  various  forms,  depend- 
ing upon  whether  it  involves  the  mucous  membranes  of 
the  mouth,  the  nasal  passages,  the  eyes,  the  intestinal  tract, 
or  the  skin.  It  is  necessary  from  a  clinical  standpoint  to 
consider  these  various  types  of  the  disease.  It  is  this  fact 
which  has  led  to  so  much  confusion  among  the  poultrymen, 
as  they  have  been  inclined  to  consider  these  forms  separate 
diseases. 

Na^al  Passages.— The  early  symptoms  are  similar  to  those 
of  an  acute  nasal  catarrh,  but  the  bird  shows  more  dulness 
and  prostration  and  there  is  present  a  peculiar  offensive 
odor.  The  odor  is  very  characteristic.  The  discharge 
from  the  nasal  passages  is  at  first  thin,  serous  and  later 
becomes  thicker  and  glutinous,  causing  the  affected  birds 
to  sneeze  and  shake  their  heads  in  an  effort  to  clear  the 
nasal  passages.  The  nasal  secretions  collect  around  the 
openings,  forming  dirty,  yellowish  crusts.  The  infra-orbital 
fossae  become  inflamed  and  distended  with  pus,  forming 
an  enlargement  on  one  or  both  sides  of  the  head  below  the 
eyes.  Owing  to  the  occlusion  of  the  nasal  passages  the  bird 
breathes  with  open  mouth. 

Eycs.—Kt  first  a  thin  serous  secretion  is  observed  flowing 
from  one  or  both  eyes;  later  it  becomes  turbid,  thicker, 
adheres  to  the  edges  of  the  eyelids  and  dries  to  form  crusts 
completely  closing  the  eye.  The  retained  yellow  material 
becomes  thicker  and  often  accumulates  to  such  an  extent 
that  it  causes  a  pronounced  bulging  of  the  eyelids.  Masses 
of  this  material  as  large  as  a  walnut  are  often  removed  from 
beneath  the  lids.  Sometimes  infection  develops  posteriorly 
to  the  eyes  in  the  form  of  abscesses  which  force  the  eyes 
partly  out  of  position.  The  cornea  is  turbid  and  often 
ulcerated.  Complete  destruction  of  one  or  both  eyes  is 
often  observed  in  severe  cases. 


EPITHELIOSIS  INFECTIOSA   AVIUM  597 

Mouth.— Involvement  of  the  mucous  membrane  of  the 
mouth  begins  as  a  local  disturbance.  The  disease  is  ushered 
in  by  a  slight  redness  or  congestion  of  isolated  areas,  or 
may  involve  the  entire  surface.  In  the  center  of  the  con- 
gested areas  there  will  appear  in  a  day  or  so  small  round 
or  oval  yellowish-white  spots,  which  rapidly  spread  and 
eventually  form  extensive  collections  of  glutinous  pus, 
having  somewhat  the  appearance  of  diphtheritic  mem- 
brane. The  nature  of  the  collected  material  on  these  areas 
led  to  the  name  "diphtheria"  for  this  form.  As  the  disease 
progresses  this  process  often  extends  over  the  entire  mucosa 
of  the  mouth,  tongue  and  throat.  When  the  larynx  is 
involved,  or  even  the  trachea,  as  is  occasionally  noted,  there 
will  be  marked  symptoms  of  dyspnea.  Asphyxia  is  fre- 
quent when  the  lesions  extend  to  the  larynx  and  trachea. 
On  removal  of  the  deposits  the  mucosa  presents  a  red, 
granulating  surface,  which  bleeds  easily,  showing  in  some 
cases  extensive  submucous  swelling  and  edema.  The  com- 
missures of  the  mouth  are  frequently  involved  as  is  the 
skin  and  contiguous  tissues,  a  characteristic  pox  lesion 
developing  in  the  skin.  Other  complications  are  frequently 
found  spreading  from  the  oral  cavity,  i.  e.,  to  the  pharynx, 
esophagus  and  crop,  producing  severe  diarrhea  and  other 
bowel  disturbances. 

Skin. — Lesions  on  the  skin  are  found  in  quite  a  few  cases, 
more  commonly  on  the  comb,  wattles  and  other  portions 
of  the  skin  not  covered  with  feathers.  It  is  first  noticed 
as  a  very  fine  gray  vesicle,  which  soon  develops  into  small 
elevations  of  a  reddish-gray  color,  which  later  become  more 
grayish.  Microscopically  the  nodules  are  composed  of 
degenerated  epithelial  cells.  These  nodules  in  some  cases 
become  quite  large,  warty  in  appearance,  dry  and  hard. 
In  severe  cases  large  numbers  of  these  nodules  are  found 
distributed  over  the  skin  on  exposed  surfaces.  On  removing 
the  surface  of  the  nodules  a  raw  granulating  area  is  noted. 
Some  cases  show  distinct  degeneration  of  contiguous  tissues. 

A  mixed  variety  of  the  disease  is  of  frequent  occurrence, 
the  mucosa  showing  the  characteristic  deposits  and  the 
skin  pox  lesions.  It  is  quite  evident  in  these  cases  that 


598  ACUTE  INFECTIOUS  DISEASES 

the  disease  spreads  from  one  location  to  the  other,  and  the 
difference  in  the  lesions  is  due  to  the  difference  in  the  struct- 
ure of  the  tissue  involved. 

General  Symptoms.— In  the  early  stages  before  much 
secondary  infection  takes  place,  there  are  no  marked  general 
symptoms.  Later  marked  general  symptoms  appear.  The 
birds  show  dulness,  assume  a  sitting  posture,  wings  are 
held  pendent,  plumage  becomes  rough  and  the  patients 
show  much  depression.  The  comb  and  wattles  grow 
bluish-red  in  color,  later  pale  and  cold.  In  the  colder 
climates  the  disease  often  assumes  a  subacute  or  chronic 
form,  while  in  warmer  climates  the  acute  form  is  more  often 
observed.  Frequently,  however,  the  disease  assumes  the 
character  of  a  chronic  catarrh. 

Diagnosis.— The  disease  usually  makes  its  first  appearance 
in  the  fall  and  often  occurs  as  the  cutaneous  form.  It  may 
be  overlooked,  especially  if  the  birds  are  on  the  range. 
The  mucous  membrane  form  usually  makes  its  appearance 
soon  after  housing  for  the  winter.  The  sneezing,  mouth- 
breathing,  occluded  nostrils  and  an  occasionally  inflamed 
eye  are  significant,  especially  when  rapidly  spreading 
through  the  flock.  Soon  after  a  few  will  refuse  food  and 
appear  depressed. 

It  must  also  be  suspected  when  similar  symptoms  appear 
after  adding  new  birds  to  a  healthy  flock  or  birds  returned 
from  shows. 

A  peculiar  characteristic  and  offensive  odor  is  associated 
with  this  disease  and  poultrymen  familiar  with  it  often 
recognize  the  disease  from  the  odor  alone.  The  same  odor 
is  given  off  by  cultures. 

Differential  Diagnosis.— Wounds  on  the  skin  around  the 
head,  usually  pick-inflicted,  appear  suspicious,  but  these 
heal  rapidly  without  extensive  thickening.  An  injury  to 
the  eye,  even  though  serious,  will  not  cause  the  formation 
of  the  characteristic  yellow  deposit.  Difficult  respiration, 
rarely  seen  in  more  than  one  bird  in  a  flock,  may  be  due  to 
several  causes,  and  those  observed  persisted  for  some  time 
without  affecting  the  general  health  of  the  bird. 


ANTHRAX  599 

Prognosis.— The  cutaneous  form  usually  runs  a  more 
favorable  course,  apparently  recovering  in  one  to  three 
weeks,  when  the  nodules  become  dry  and  scale  off.  The 
mucous  membrane  form  is  less  favorable,  the  mortality 
varying  from  10  to  50  per  cent.,  depending  on  the  care  and 
sanitary  surroundings. 

Aside  from  the  actual  number  that  die  we  find  there  is 
considerable  loss  resulting  from  the  chronic  effects.  After 
the  disappearance  of  all  visible  lesions  the  birds  do  not 
seem  to  regain  their  former  good  condition  for  months. 
Egg  production  is  far  below  normal,  and  young  birds  have 
their  growth  checked. 

Treatment. — There  have  been  a  great  many  drugs  recom- 
mended in  the  treatment  of  this  disease,  and  so  far  none 
of  them  have  proved  very  satisfactory.  Daily  treatment 
of  individual  birds  is  a  tedious  and  laborious  task,  especially 
where  large  flocks  are  affected. 

The  lesions,  whether  on  the  skin  or  in  the  mouth,  should 
be  washed  with  antiseptics,  boric  acid  solution  (2  per  cent.), 
potassium  permanganate  (0.25-1  per  cent.),  or  any  other 
equally  efficient  antiseptic.  The  deposits  should  be  removed 
with  a  curette  or  dull  knife  before  applying  the  antiseptic. 

Vaccine.— Vaccination  has  proved  very  satisfactory  in  this 
disease.  One  c.c.  is  administered  subcutaneously,  and  in 
severe  cases  it  should  be  repeated  in  four  to  six  days. 

Prevention.— All  newly  acquired  birds  should  be  examined 
and  isolated  for  at  least  ten  days  before  allowing  them  to 
come  in  contact  with  the  regular  flock. 

As  soon  as  the  disease  is  recognized,  it  is  recommended 
that  all  birds  be  vaccinated  immediately  to  check  it. 
Healthy  flocks  and  those  intended  for  exhibition  purposes 
may  be  vaccinated  to  establish  immunity.  This  has  proved 
very  satisfactory.  The  immunity  established  will  last  for 
at  least  six  months  to  one  year. 

ANTHRAX. 

This  disease  is  essentially  found  in  large  animals.  (See 
other  works.) 


000  ACUTE  INFECTIOUS  DISEASES 

FOOT-AND-MOUTH  DISEASE. 

Aphthce  Epizooticce. 

Foot-and-mouth  disease  rarely  occurs  in  carnivora,  but 
has  been  observed  in  a  few  cases  in  dogs.  Dogs  kept  on 
infected  premises  in  contact  with  infected  cattle,  especially 
those  that  are  used  for  herding  animals  are  the  ones  most 
liable  to  be  affected.  Dogs  are  not  very  susceptible  to  the 
infection,  and  take  it  in  a  mild  form.  The  principal  symp- 
toms are  vesicles  on  the  mucous  membranes  of  the  lips, 
sometimes  forming  ulcers,  which  penetrate  more  or  less 
deeply  into  the  tissues.  Sometimes  the  feet  become  involved, 
when  there  will  appear  a  vesicular  exanthema  on  the  balls 
of  the  feet  and  between  the  toes.  The  feet  will  be  swollen, 
hot  and  sensitive,  and  the  patient  very  lame.  General 
symptoms,  such  as  elevation  of  temperature,  diarrhea,  loss 
of  appetite  and  vomiting  have  been  observed.  The  disease 
has  made  its  appearance  in  fowls,  but  only  in  a  few  instances 
has  it  been  recorded. 

HEMORRHAGIC  SEPTICEMIA  OF  CATS. 

Infectious  G astro-enteritis. 

History.— This  disease  has  been  reported  as  occurring  in 
various  sections  of  the  United  States  and  Europe.  So  far 
but  little  is  known  about  it  as  the  disease  is  a  comparatively 
new  one. 

Occurrence.  — Cat  septicemia  occurs  enzootically,  espec- 
ially among  cats  congregated  as  in  catteries  and  shows. 

Etiology.— The  disease  seems  to  be  produced  by  a  specific 
organism  (Bacterium  felisepticus  bipolaris  of  Huse  and 
Coleman).  It  is  described  as  a  short,  rod-shaped  organism, 
taking  the  bipolar  stain  readily  with  the  common  stains,  but 
is  Gram-negative. 

Pathogenicity . — The  work  up  to  the  present  time  indicates 
the  pathogenicity  of  this  organism  is  confined  to  cats,  rabbits 
and  guinea  pigs.  Dogs  and  birds  show  no  tendency  toward 
natural  infection. 


HEMOKRHAGIC  SEPTICEMIA  OF  CATS  (>01 

Pathogenesis.— The  organisms  are  evidently  taken  into 
the  digestive  tract  with  the  food  and  drink.  The  organisms 
multiply  very  rapidly  and  induce  in  a  very  short  period  of 
time  a  severe  hemorrhagic  gastro-enteritis.  The  severity 
of  the  disease  depends  upon  the  natural  resistance  of  the 
animal  and  the  virulency  of  the  infection. 

Symptoms.— The  period  of  incubation  is  from  two  to  five 
days.  The  development  of  the  symptoms  is  very  rapid. 
The  disease  is  ushered  in  by  a  sudden  suppression  of  the 
appetite,  vomiting,  retching,  marked  depression  and  general 
weakness.  The  animal  shows  a  tendency  to  seek  dark  cool 
places  and  lies  stretched  out  on  its  abdomen.  The  tem- 
perature rises  rapidly  after  the  onset  reaching  103-106°  F. 
in  twelve  to  twenty-four  hours.  The  temperature  remains 
high  during  the  early  part  of  the  disease,  but  later  becomes 
normal  or  subnormal.  Emaciation  comes  on  rapidly,  a 
profuse  diarrhea  is  present,  the  feces  having  a  characteristic- 
fetid  odor.  As  the  disease  progresses  the  animal  becomes 
weak,  eyes  retracted  and  staring.  In  three  to  four  days 
coma  develops,  and  death  follows  in  the  course  of  a  few 
hours.  The  course  is  very  rapid  in  acute  cases,  ^ome 
few  cases  assume  a  subacute  form,  and  the  symptoms  are 
milder  but  progressive. 

Pathology.— A  more  or  less  severe  gastro-enteritis  hemor- 
rhagica  is  typical  of  this  disease.  The  entire  mucosa  of  the 
digestive  tract  is  highly  congested  and  dotted  over  the 
surface  with  petechia>  and  numerous  patches  of  ecchymoses. 
The  membrane  is  covered  with  a  catarrhal  exudate  which 
in  the  majority  of  cases  contains  some  blood.  The  serous 
covering  of  the  intestines  shows  marked  congestion,  but  no 
petechirt'.  The  presence  of  gas  in  the  stomach  and  bowels  is 
quite  constant.  The  stomach  particularly  is  nearly  always 
found  distended.  The  heart  muscle,  liver  and  kidneys  show- 
signs  of  rapid  degeneration.  The  gall-bladder  is  greatly 
distended,  and  the  bile  is  dark  colored,  thick  and  tenaceous. 
The  lungs  may  show  congestion,  and  in  subacute  attacks 
pneumonic  areas.  Other  cases  may  not  show  changes  in 
the  lungs. 


602  ACUTE  INFECTIOUS  DISEASES 

Diagnosis.— The  disease  is  recognized  by  its  contagious 
character,  its  rapid,  severe  course  and  the  profuse  diarrhea. 
The  absence  of  catarrhal  symptoms  of  the  air  passages  and 
eyes  would  assist  in  differentiating  it  from  distemper. 
Ptomains  or  mineral  poisons  will  produce  similar  symptoms, 
but  the  microscopic  examination,  the  contagious  character 
and  the  investigation  of  the  food  supply,  history  of  poison- 
ing, etc.,  will  serve  to  make  clear  the  differentiation.  It 
is  very  important  to  be  able  to  make  an  accurate  diagnosis 
for  the  protection  of  other  animals. 

Prognosis.— The  prognosis  is  bad.  Even  in  the  early 
period  of  the  disease,  and  in  the  apparently  mild  cases,  it 
should  be  looked  upon  as  a  very  serious  condition.  The 
mortality  is  very  high,  from  80  to  90  per  cent,  of  the  cases 
terminating  fatally. 

Treatment.— There  is  no  treatment  known  that  has 
much,  if  any,  effect  on  the  course  of  the  disease.  Sympto- 
matic treatment  is  the  only  thing  that  can  be  done.  A 
vaccine  is  being  used  as  a  prophylactic  treatment,  but  at 
present  it  is  difficult  to  say  what  the  results  will  prove  to 
be.  An  antisera  is  also  being  used  at  present  and  gives 
considerable  promise  of  success  as  a  curative  and  preventive 
agent.  The  progress  of  the  disease,  after  it  once  breaks  out 
in  a  hospital  or  cattery  can  be  curtailed  only  by  removing 
all  sick  and  exposed  animals,  and  thoroughly  disinfecting 
the  rooms  with  formaldehyd  gas.  All  utensils,  litter,  etc., 
should  be  rendered  innoxious.  Prevention  is  far  more 
important  than  treatment. 


CHAPTER   III. 

INFECTIOUS  DISEASES  WITH  SPECIAL  INVOLVE- 
MENT OF  THE  NERVOUS  SYSTEM. 

RABIES. 

Hydrophobia .  Lyssa . 

Definition.- An  acute  infectious  disease,  fatal  in  the 
majority  of  cases,  and  characterized  clinically  by  disturb- 
ance of  consciousness,  marked  irritability  and  later  by 
.symptoms  of  paralysis. 

Occurrence.  — Rabies  is  one  of  the  oldest  known  diseases 
and  has  been  observed  in  all  countries.  It  is  most  com- 
monly noted  in  dogs,  cats,  wolves  and  foxes.  Other  animals 
are  less  commonly  affected.  It  is  estimated  that  about 
90  per  cent,  of  the  cases  of  rabies  occur  in  dogs.  The 
disease  often  occurs  enzootically,  which  may  be  at  any 
season  of  the  year.  The  larger  number  of  outbreaks  in  the 
I  nited  States  has  been  in  the  colder  months  of  the  year. 
Outbreaks  are  naturally  more  frequent  where  dogs  congre- 
gate, and  in  communities  or  cities  where  there  are  no  pro- 
tective regulations.  In  some  countries  and  districts  rabies 
is  decreasing,  due  to  proper  police  regulations  which  restrict 
the  number  of  dogs  running  at  large. 

Etiology.— Kabies  is  produced  by  an  ultramicroscopic 
virus.  This  virus  is  found  to  be  the  most  virulent  when 
taken  from  the  central  nervous  system  (brain  and  cord), 
less  so  from  the  peripheral  nerves,  salivary  and  other  glands 
and  their  secretions.  The  infection  does  not  seem  to  be 
present  in  the  blood  of  affected  animals.  The  infectious 
agent  is  fixed,  non-volatile  and  is  an  obligatory  or  fixed 
parasite. 

Pathogenicity.— The  disease  is  readily  transmitted  to 
dogs,  rabbits,  guinea  pigs  and  other  animals  by  inoculating 


004  INFECTIOUS  DISEASES 

them  with  the  virulent  saliva,  or  an  emulsion  of  the  cornu 
ammonis,  medulla  ohlongata,  and  some  other  portions  of 
central  nerve  tissue.  The  most  satisfactory  results  are 
obtained  by  injecting  some  of  the  virus  under  the  dura 
mater  of  the  brain  or  cord.  The  same  inoculation  may  be 
made  into  the  anterior  chamber  of  the  eye,  or  into  the 
muscles,  but  the  results  are  not  so  certain.  Injection  of 
the  virus  into  or  around  the  peripheral  nerves  has  produced 
the  disease  quite  constantly.  Scarification  of  the  skin  and 
rubbing  the  virus  on  the  area  has  produced  positive  results 
only  in  about  40  per  cent,  of  the  cases.  Other  methods  of 
inoculation  have  been  less  successful.  Birds  may  be  infected 
by  inoculation. 

Natural  Infection. — Rabies  is  produced  in  practically  all 
cases  by  the  victim  being  bitten  by  a  rabid  animal,  intro- 
ducing the  virulent  saliva  into  the  wound,  to  come  in  con- 
tact with  the  nerves,  muscles,  or  subcutaneous  tissues. 
Rarely  are  cases  produced  by  the  infectious  agent  being 
licked  from  wounds,  or  from  contact  with  lesions  on  the  skin. 

Pathogenesis.  — When  the  virus  is  introduced  into  some 
part  of  the  body  through  a  bite  by  another  animal,  or  by 
inoculation  artificially,  it  is  supposed  that  it  follows  the 
course  of  peripheral  nerve  fibers  along  which  it  is  carried 
to  the  central  nervous  system.  The  explanation  of  the 
development  of  the  two  types  of  the  disease  is  explained 
by  the  path  of  travel  to  the  central  system,  whether  it 
reaches  the  brain,  medulla  oblongata,  or  the  spinal  cord. 
Alter  the  virus  reaches  the  central  nervous  system  to  pro- 
duce irritation  on  certain  groups  of  cells,  it  is  then  centrifu- 
gally  distributed  to  different  parts  of  the  body.  It  reaches 
the  salivary  glands,  which  favors  the  development  of  the 
virus,  increasing  the  secretion  of  the  glands,  and  then  is 
further  disseminated  through  the  saliva.  The  period  of 
incubation  of  rabies  is  quite  variable.  The  virus  after 
being  introduced  into  a  wound  may  remain  in  a  dormant 
state  for  some  time  before  reaching  the  central  nervous 
system.  The  variation  in  susceptibility  of  animals  in  the 
virulency  of  the  infection,  and  the  method  of  the  dissemina- 
tion of  the  virus  in  the  body  naturally  make  the  period  of 


RABIES  605 

incubation  rather  long.  Three  to  seven  weeks  is  the  usual 
time  for  development  in  dogs.  However,  some  cases 
develop  only  after  several  months.  The  period  of  incu- 
bation in  cats  and  fowls  is  usually  shorter  than  in  dogs. 
The  period  of  incubation  is  usually  shorter  in  young  animals. 
The  toxicity  of  rabies  virus  and  the  pathogenic  action  on 
the  tissues  are  no  doubt  due  to  some  chemical  product  which 
up'  to  the  present  has  not  been  determined. 

Pathology.— The  disease  is  really  characterized  by  the 
absence  of  any  marked  gross  pathological  findings.  The 
lesions  vary  somewhat  in  individual  cases.  The  digestive 
tract  shows  congestion  and  hyperemia.  The  stomach  may 
be  contracted  and  empty,  or  is  frequently  partially  filled 
with  foreign  material  such  as  stones,  straw,  sticks,  splinters 
of  wood,  hair,  feathers,  etc.  The  folds  of  the  mucous  mem- 
brane are  markedly  congested  on  their  summits.  Hemor- 
rhage sometimes  occurs  from  the  foreign  material  cutting 
or  tearing  the  mucosa.  The  mucosa  of  the  pharynx  and 
larynx  shows  congestion  and  is  covered  with  mucus.  An 
acute  catarrhal  inflammation  of  the  respiratory  passages 
is  frequently  found.  The  brain  and  its  coverings  are  often 
injected  with  small  hemorrhages.  No  other  lesions  of  any 
importance  are  observed. 

Symptoms.— From  a  clinical  standpoint  it  is  necessary 
to  divide  rabies  into  two  types,  viz:  (1)  Furious  rabies, 
and  (2)  dumb  rabies.  The  different  train  of  symptoms 
depends  entirely  upon  whether  the  brain  or  spinal  cord  is 
primarily  involved.  However,  cases  are  observed  occa- 
sionally where  an  animal  affected  with  dumb  rabies  suddenly 
develops  the  furious  type.  The  dumb  or  mute  rabies  seems 
to  be  the  most  common  form  in  the  United  States. 

1.  FURIOUS  RABIES.— In  this  form  three  stages  of  devel- 
opment are  rather  sharply  defined :  (a)  Melancholic  or  pro- 
dromic  stage;  (b)  maniacal  or  irritative  stage;  (c)  paralytic 
stage. 

(a)  Stage  of  Melancholy.— In  the  stage  of  melancholy  or  in 
the  beginning  of  the  disease,  the  first  thing  usually  noted  by 
the  owner  is  the  altered  behavior  of  the  animal.  It  becomes 
sullen,  afraid,  seeks  dark  places,  is  easily  irritated,  restless  and 


(JOG  INFECTIOUS  DISEASES 

obstinate  (often  does  not  obey  its  master).  The  patient 
is  also  inclined  to  hide  itself,  alternately  gets  up  and  lies 
down  frequently,  makes  sudden,  unusual  movements,  such 
as  snapping  or  biting  at  imaginary  objects,  or  barks  sud- 
denly without  any  cause.  During  the  early  stage  of  the 
disease  the  appetite  is  not  much  changed,  but  later  the 
manner  of  eating  and  the  kind  of  food  chosen  are  greatly 
modified.  Dogs  are  inclined  to  eat  indigestible  objects, 
such  as  pieces  of  wood ;  eat  their  own  feces  and  lap  up  their 
own  urine,  etc.  A  very  noticeable  symptom  is  the  tendency 
to  grasp  objects  as  if  to  eat  them,  then  suddenly  let  them 
fall  from  the  mouth.  Constipation  is  usually  present  in 
this  stage.  During  the  latter  part  of  this  stage  the  patient 
is  excitable.  The  patient  shows  a  marked  change  in  dis- 
position, snaps  at  objects,  its  master,  other  persons  or 
other  animals.  This  excitability  is  more  noticeable  toward 
strange  persons  or  animals.  Sometimes  the  patient  mani- 
fests no  change  in  disposition  toward  its  master,  familiar 
persons  or  animals.  The  excitability  gradually,  or  very 
rapidly,  increases.  The  nervous  reflexes  become  sensitive 
and  the  patient  is  easily  startled  by  sudden  noises,  touch- 
ing objects  or  by  strong  light.  The  pupil  of  the  eye  dilates 
and  the  facial  expression  is  changed.  Dyspnea  is  prominent 
at  times.  The  patient  will  often  scratch  or  bite  the  place  of 
infection,  sometimes  doing  extensive  injury  to  the  area. 
The  appetite  is  entirely  suppressed  but  the  animal  seeks 
water  and  attempts  to  drink,  but,  on  account  of  the  begin- 
ning paralysis  of  the  larynx  and  pharynx,  does  not  succeed. 
The  salivary  secretion  is  increased,  and  saliva  hangs  from 
the  mouth  in  long  strands.  This  stage  usually  lasts  from 
one  to  three  days. 

(b)  Sbigr.  of  Irritation . —  In  this  stage  the  symptoms  reach 
a  higher  degree  of  development.  The  excitement  increases; 
hallucinations,  which  bring  about  violent  fury  or  rage,  are 
soon  apparent.  The  voice  of  the  animal  changes  decidedly 
from  the  normal.  This  is  a  very  characteristic  symptom 
of  rabies,  and  no  doubt  results  from  the  congestion  and 
paralysis  of  the  vocal  cords.  The  owner's  attention  is 
always  attracted  by  the  unusual  amount  of  barking  and 


RABIES  607 

the  change  in  the  voice.  At  this  stage  they  become  vicious, 
and  if  confined  show  a  tendency  to  chew  objects  and  tear 
them  to  pieces.  Rugs,  carpets,  or  other  objects  with  which 
they  come  in  contact  are  torn  and  destroyed.  At  this 
time  if  they  are  not  confined  they  will  usually  wander 
away  from  home,  biting  other  animals  or  persons  that  hap- 
pen to  come  in  their  path.  Often  during  a  short  period  of 
time  they  will  travel  long  distances  before  returning,  which 
they  invariably  do.  Upon  their  return  they  show  emacia- 
tion, exhaustion,  often  wounds  from  being  bitten  by  other 
animals,  and  in  general  have  a  dejected  appearance.  The 
desire  to  bite  aimlessly  objects  and  animals  is  quite  char- 
acteristic of  this  stage.  A  rabid  dog  in  this  stage  may 
inoculate  a  large  number  of  animals  unless  confined.  ,When 
confined  in  a  cage  or  room  they  show  at  times  intense  fury 
and  viciousness.  If  irritated,  by  placing  a  stick  between 
the  bars  of  the  cage,  the  dog  will  attack  it  viciously,  but 
shows  the  peculiar  symptom  of  simply  biting  instead  of 
holding  on  to  the  stick  as  non-rabid  dogs  ordinarily  do. 
As  this  stage  progresses  the  periods  of  fury  become  shorter, 
and  soon  marked  depression  is  noted.  Paralysis  of  some  of 
the  special  nerves  develops,  shown  by  the  increase  in  the 
change  of  the  voice,  which  becomes  a  peculiar  wail  or  howl, 
and  the  difficulty  in  swallowing.  The  eyes  are  congested, 
and  also  the  mucous  membranes  of  the  mouth.  This  stage 
of  fury  lasts  usually  two  to  four  days. 

(c)  Paralytic  Stage.— The  symptoms  of  paralysis  become 
more  pronounced,  and  the  patient  is  less  vicious.  Complete 
loss  of  voice  and  the  inability  to  swallow,  with  paralysis 
of  the  tongue  and  masseter  muscles,  are  early  symptoms  of 
this  stage.  The  mouth  is  held  open,  the  dry  tongue  is  pro- 
truded and  completely  paralyzed.  The  eyes  are  retracted, 
lose  their  expression  and  luster;  the  pupils  become  dilated, 
in  some  cases  unequally.  The  animal  shows  marked  gen- 
eral emaciation,  the  hair  coat  rough  and  there  is  much 
exhaustion.  The  general  paralysis  asserts  itself,  beginning 
in  most  cases  at  the  tail  and  posterior  limbs.  The  animal 
has  difficulty  in  walking  or  standing;  later  there  is  complete 
paralysis  of  the  posterior  part  of  the  body.  The  paralysis 
rapidly  ascends  to  the  fore  parts  and  central  nervous  sys- 


008  INFECTIOUS  DISEASES 

tern,  causing  death  in  most  cases  on  the  fifth  to  eighth  day 
of  the  attack.  The  temperature  in  rabies  has  not  been 
recorded  in  many  cases.  During  the  early  stages  it  is 
elevated  to  104°-io6°  F. ;  later  becomes  subnormal.  Varia- 
tions in  the  symptoms  of  furious  rabies  are  observed,  but 
most  cases  present  a  rather  constant  clinical  picture. 

The  symptoms  of  furious  rabies  in  cats  are  very  similar 
to  those  of  dogs.  They  often  become  very  vicious,  and 
bite  and  scratch  everything  that  they  come  in  contact 
with.  The  change  of  voice  is  also  quite  noticeable.  The 
course  of  the  disease  is  usually  shorter,  lasting  from  three 
to  six  days. 

2.  DUMB  RABIES.— This  form  is  characterized  by  a 
paralysis  of  the  lower  jaw,  tongue,  larynx  and  pharynx. 
This  symptom  develops  early  in  the  disease  and  is  the  most 
prominent  one  until  general  paralysis  manifests  itself. 
The  owner  is  often  led  to  suspect  that  the  animal  has  a 
bone  or  some  other  object  lodged  between  its  teeth,  or 
in  its  throat.  All  such  cases  should  be  looked  upon  with 
suspicion,  and  all  precautions  taken  in  making  the  exami- 
nation. In  the  majority  of  cases  no  nervous  or  excitable 
symptoms  are  shown;  the  paralytic  symptoms  gradually 
becoming  more  pronounced  until  the  animal  succumbs  to 
general  paralysis.  Cases  are  observed  occasionally  where 
symptoms  of  excitement  develop  during  the  course  of  the 
disease.  One  such  case  was  observed  in  which  the  early 
symptoms  indicated  dumb  rabies  but  in  twenty-four  hours 
all  the  symptoms  of  the  furious  form  had  developed.  Ani- 
mals with  this  form  of  the  disease  usually  seek  dark,  cool 
places  and  lie  almost  constantly. 

There  is  the  same  peculiar  expression  from  the  eyes  as 
in  the  other  form.  The  patient  often  attempts  drinking 
or  eating  which  the  paralysis  prevents.  There  is  usually 
no  tendency  to  bite  nor  viciousness  manifested. 

Rabies  in  rabbits  nearly  always  assumes  the  paralytic 
form.  Fowls  show  the  characteristic  symptoms  of  furious 
rabies  in  some  cases,  such  as  excitement,  change  of  voice, 
ruffled  plumage,  attacking  other  fowls,  people,  etc.  In  other 
instances  the  paralytic  form  is  observed. 

Diagnosis.— In    furious    rabies    the    diagnosis    does    not 


RABIES  609 

present  any  great  difficulty  where  the  symptoms  are  pro- 
nounced and  the  animal  observed  through  the  different 
stages.  The  positive  proof  of  a  bite  inflicted  previously 
by  another  animal  is  of  considerable  importance  in  mak- 
ing the  diagnosis.  An  accurate  diagnosis  is  of  great  impor- 
tance for  two  reasons,  viz.:  (a)  In  case  human  subjects  are 
bitten,  or  in  any  way  inoculated,  it  will  give  them  an  oppor- 
tunity to  receive  the  antirabic  treatment  early;  and  (6) 
to  protect  other  animals  and  persons  from  becoming  inocu- 
lated by  quarantining  and  confining  the  animal.  Under  no 
circumstances  should  an  animal  showing  symptoms  of  rabies, 
or  suspected  of  having  the  disease,  be  killed.  It  should 
be  put  in  quarantine  and  observed.  It  has  been  demon- 
strated that  animals  destroyed  early  in  the  disease  often 
do  not  show  positive  findings  on  microscopic  examination. 
The  characteristic  symptoms  of  irritation,  tendency  for 
biting,  change  of  voice,  paralysis,  etc.,  generally  show  evi- 
dence enough  to  the  experienced  clinician  to  establish  the 
diagnosis.  The  detection  of  Negri  bodies  on  microscopic 
examination  will  make  the  diagnosis  positive.  In  dumb 
rabies  the  diagnosis  is  made  on  the  characteristic  symptoms 
of  paralysis  of  the  lower  jaw,  the  somnolence  in  most  cases, 
the  expression  and  the  paralysis  of  other  parts  of  the  body 
in  the  course  of  two  to  four  days.  All  cases  showing  the 
symptoms  of  the  lower  jaw  hanging  down  should  be  diag- 
nosed dumb  rabies  until  ample  proof  is  shown  that  it  is  some 
other  condition.  Microscopic  examination  of  the  brain 
should  be  made  to  establish  the  diagnosis  as  in  furious 
rabies.  Intracranial  inoculations  of  rabbits  have  been  used 
extensively  in  making  a  positive  diagnosis.  This  method 
requires  from  fourteen  to  seventeen  days,  and  is  falling 
into  disuse.  Inoculations  of  the  virus  in  guinea  pigs  have 
also  been  used  extensively  as  a  diagnostic  measure. 

Prognosis  and  Course.— The  disease  is  fatal  in  practically 
all  cases.  The  possibility  of  recovery  in  very  mild  cases 
cannot  be  denied.  However,  no  authentic  case  of  recovery 
has  been  recorded.  It  has  been  estimated  that  only  about 
17  to  20  per  cent,  of  the  animals  bitten  by  known  rabid 
animals  develop  rabies.  This  percentage  is  higher  in  dogs 
than  in  any  other  small  animal.  The  course  of  the  disease 
39 


filf)  INFECTIOUS  DISEASES 

is  quite  constant  in  the  different  animals,  although  variations 
occur  occasionally.  Five  to  seven  days  is  the  usual  course; 
it  may  be  in  exceptional  cases  as  short  as  two  days  or  as 
long  as  ten  or  eleven  daj's.  There  is  but  little  difference 
in  the  course  of  the  two  forms;  usually  dumb  rabies  runs  a 
longer  course  than  the  furious  type. 

Differential  Diagnosis.— There  are  quite  a  number  of 
diseases  in  small  animals  which  might  be  confused  with 
rabies:  (a)  Diseases  of  the  brain,  particularly  inflammations 
involving  the  meninges  and  the  cerebral  substance  itself. 
In  these  cases  irritability  and  nervousness  are  present,  but 
the  tendency  to  bite,  the  aggressiveness,  change  in  voice 
and  development  of  the  paralysis  in  the  same  way  are 
absent.  If  there  should  be  any  doubt  the  animal  must  be 
confined  and  observed  for  a  few  days  when  the  differentia- 
tion will  not  be  difficult.  (6)  Canine  distemper  (nervous 
form)  sometimes  simulates  rabies,  but  the  history  of  the 
case,  the  other  symptoms  of  distemper  and  the  length  of 
the  course  of  the  disease  will  reveal  the  difference,  (c) 
Parasites  in  the  intestinal  tract  often  produce  certain 
nervous  phenomena,  but  of  different  development  and  type 
than  rabies.  Many  of  the  characteristic  symptoms  of 
rabies  are  absent,  (d)  Other  parasites  (Linguatula 
rhinaria,  Dioctophyme  renale,  Spiroptera  sanguinolenta, 
Otodectes  cynotis)  may  produce  certain  nervous  symp- 
toms, but  careful  examination  and  observation  of  the 
animal  will  readily  distinguish  the  difference,  (e)  Foreign 
bodies  lodged  between  the  teeth,  around  the  tongue  or  in 
the  pharynx  all  induce  salivation,  hoarseness  from  the 
accompanying  edema  and  cause  the  mouth  to  remain  open. 
These  cases  should  be  examined  very  carefully  to  differ- 
entiate them  from  rabies.  In  most  of  these  cases  it  is 
impossible  to  close  the  mouth,  which  is  not  true  in  rabies, 
and  there  are  no  general  symptoms.  (/)  Trigeminal  or 
facial  paralysis  is  observed  occasionally  in  the  course  of 
distem])cr,  or  as  an  independent  condition.  In  these  cases 
there  are  no  other  symptoms  of  paralysis,  nor  any  general 
symptoms.  The  course  is  longer  and  the  animal  remains 
otherwise  normal,  (g)  Epilepsy  might  be  confused  with 


RABIES  611 

rabies.  But  this  condition  comes  on  suddenly  and  lasts 
only  a  few  minutes  to  disappear  completely  until  the  next 
attack,  (h)  Eclampsia  is  differentiated  by  its  occurrence 
in  bitches  at  or  near  the  time  of  whelping,  clonic  spasms 
which  affect  the  entire  body  and  none  of  the  other  char- 
acteristic symptoms  of  rabies,  (i)  Infectious  bulbar  paral- 
ysis in  which  the  symptoms  are  quite  similar  to  rabies. 
It  is  distinguished  from  rabies  by  the  absence  of  the  furious 
attacks,  viciousness  and  paralysis  of  the  lower  jaw.  The 
blood  and  brain  tissue  are  infectious  and  the  saliva  not. 
This  disease  develops  suddenly  and  runs  a  more  rapid 
course  than  rabies.  Finally,  there  are  a  few  conditions  in 
which  the  animal  will  show  more  or  less  nervousness,  but 
none  of  the  other  symptoms  of  rabies.  Animal  inoculation 
and  the  microscopic  examination  of  the  brain  should  be 
made  in  all  cases  of  doubt. 

Treatment.— After  rabies  has  once  developed  in  an  animal 
no  treatment  will  have  any  effect  on  the  disease.  Bitten 
wounds  that  have  been  caused  by  a  rabid  animal  should 
be  treated  promptly.  They  should  be  opened  freely,  and 
if  hemorrhage  takes  place  it  is  all  the  better,  as  it  will  tend 
to  remove  the  virus  from  the  wound.  The  wound  should 
be  washed  freely  and  thoroughly  with  potassium  perman- 
ganate solution  (1  per  cent.),  or  bichlorid  solution  (1  to 
1000).  Cauterization  of  the  wound  with  silver  nitrate  is 
also  recommended.  The  success  of  this  treatment  in  pre- 
venting the  development  of  the  disease  will  depend  upon 
the  length  of  time  which  has  elapsed  after  the  bite,  and  the 
thoroughness  in  which  the  antiseptic  or  caustic  is  applied. 
Disinfection  of  the  wound  alone  should  not  be  depended 
upon  for  the  prevention  of  rabies. 

Preventive  Inoculation.— Preventive  inoculation  is  being 
used  with  great  success  in  animals,  and  is  highly  recommended 
in  all  cases  where  there  is  any  doubt  about  the  animal 
being  infected. 

INFECTIOUS  BULBAR  PARALYSIS. 

Pseudorabies. 

Definition.— An  infectious  disease  affecting  dogs,  cats,  rats, 
horses  and  cattle  resembling  rabies  in  many  respects. 


612  INFECTIOUS  DISEASES 

Etiology.— This  disease  is  produced  by  a  specific  virus, 
the  nature  of  which  has  not  been  determined.  All  animals 
except  fowls  are  susceptible  to  inoculations  with  the  virus 
which  is  found  in  the  blood,  central  nervous  system,  and 
in  some  of  the  other  tissues.  The  saliva,  bile  and  urine  are 
free  from  the  virus. 

Pathogenicity.— Most  animals  are  very  susceptible  to 
infection  by  inoculating  them  with  only  minute  quantities 
of  the  blood,  or  central  nerve  tissues,  from  those  affected 
with  the  disease.  At  the  point  of  inoculation,  the  tissues 
become  red  and  inflamed;  later,  necrotic.  The  inoculated 
wound  shows  intense  irritation,  and  the  animal  bites  and 
scratches  the  part  almost  continuously.  Dogs  and  cats 
contract  the  disease  readily  after  being  fed  on  organs  or 
tissues  containing  the  virus. 

Natural  Infection.— This  has  not  been  definitely  established, 
but  probably  in  most  cases  is  due  to  eating  infected  meats, 
or  being  inoculated  by  infected  mice  or  rats. 

Pathology.— No  marked  lesions  are  found  in  this  disease, 
except  at  the  point  of  inoculation.  The  meninges  of  the 
brain,  and  the  brain  substance,  usually  show  hyperemia, 
and  blood  extravasations.  When  infection  takes  place  in 
cats  and  dogs  from  eating  infected  meat,  the  stomach  and 
small  intestines  are  congested,  and  in  some  cases  markedly 
inflamed.  Hemorrhages  under  the  mucosa,  and  frequently 
petechise  on  the  serous  membranes  of  the  stomach  and  intes- 
tines are  noted.  No  other  lesions  are  found. 

Symptoms.— The  period  of  incubation  varies  from  two  to 
nine  days.  The  onset  of  the  disease  is  characterized  in  the 
dog  and  cat  by  a  sudden  change  in  disposition,  tendency  to 
seek  dark,  cool  places,  where  the  patient  lies  quietly  or 
maintains  a  crouching  attitude.  They  often  cry  or  mew 
as  if  in  severe  pain.  Vomiting  is  more  or  less  persistent, 
there  is  complete  loss  of  appetite,  and  marked  salivation. 
Severe  itching  is  manifested  in  most  cases  by  the  animal 
scratching  and  biting  itself,  sometimes  so  severely  that  the 
skin  is  entirely  removed  over  the  involved  area,  usually 
around  the  lips  or  face.  In  some  few  cases  this  symptom  may 


TETANUS.— LOCKJAW  613 

be  absent.  As  the  disease  progresses  the  animal  shows  more 
pain  by  howling,  crying,  or  groaning.  The  muscles  around 
the  head  and  face  often  show  marked  twitching,  which  may 
be  periodical  or  constant.  The  nervous  system  is  affected  as 
is  shown  by  increased  reflex  excitability,  paralysis  of  the 
pharynx  and  larynx,  and  increased  muscular  sensitiveness. 
There  is  marked  dyspnea.  The  temperature  is  usually  normal 
or  subnormal ;  toward  the  end  the  subnormal  temperature  is 
very  marked.  The  animal  usually  dies  in  about  thirty-six 
to  forty  hours. 

Diagnosis.— There  might  be  some  difficulty  in  establishing 
an  accurate  diagnosis.  However,  the  symptoms,  which  are 
quite  constant,  and  the  rapid,  fatal  course,  would  assist. 

Differential  Diagnosis.— In  the  dog  and  cat  it  is  necessary 
to  distinguish  this  disease  from  rabies.  The  chief  points  of 
difference  are  the  following:  (a)  Rabies  (furious)  is  charac- 
terized by  symptoms  of  rage  or  fury,  aggressiveness;  in  dumb 
rabies  by  paralysis  of  the  lower  jaw.  Both  are  absent  in 
bulbar  paralysis,  (b)  The  saliva  in  rabies  is  highly  infectious 
while  in  this  disease  it  is  non-infectious,  (c)  The  period  of 
incubation  is  usually  from  two  to  nine  days,  while  in  rabies, 
although  variable,  it  is  much  longer.  On  account  of  its  rapid 
course,  it  might  easily  be  mistaken  for  some  acute  poisoning. 
Should  the  symptom  of  itching  and  irritation  be  absent  a 
differentiation  would  be  quite  difficult.  In  such  cases  experi- 
mental inoculation  with  the  blood  of  the  affected  animal  into 
healthy  ones  will  assist.  Frequently,  a  number  of  animals 
in  a  neighborhood  will  become  infected  at  the  same  time,  the 
disease  appearing  in  the  form  of  an  enzootic. 

Prognosis.— Very  unfavorable.    The  majority  of  cases  die. 

Treatment.— Treatment  is  unsatisfactory.  Antiseptics  for 
the  digestive  tract  may  be  tried.  Thorough  disinfection  is 
necessary  in  order  to  check  the  disease.  All  dead  animals 
should  be  burned  or  buried  in  lime  to  destroy  the  virus. 

TETANUS.     LOCKJAW. 

Definition.— An  acute,  infectious  disease,  characterized  by 
involvement  of  the  nervous  system,  resulting  in  spasmodic 


614  INFECTIOUS  DISEASES 

contractions  of  certain  groups  of  muscles,  or  the  entire  mus- 
culature of  the  animal's  body,  without  that  consciousness 
is  disturbed. 

Occurrence.— Tetanus  is  of  rare  occurrence  in  small  animals. 
It  is  observed  occasionally  in  dogs  and  birds.  It  is  far  more 
common  in  the  large  domesticated  animals. 

Etiology.— It  is  produced  by  a  specific  bacillus  (Bacillus 
tetani  of  Nicolaier). 

Natural  Infection.— Infection  takes  place  by  the  bacilli  or 
spores  gaining  entrance  to  wounds  in  the  skin  or  mucous 
membranes.  The  most  common  intermediate  carrier  of  the 
infection  is  the  soil  or  earth  which  comes  in  contact  with 
the  wounds.  Rarely  is  the  disease  spread  from  one  animal 
to  another. 

Pathology.— The  postmortem  is  usually  negative.  The 
affected  muscles  are  usually  pale,  or  may  show  occasional 
hemorrhages.  The  condition  of  the  blood  indicates  in  most 
cases  that  death  is  due  to  suffocation.  Other  lesions  are 
inconstant  and  of  minor  importance. 

Symptoms.  — General  tetanus  is  of  rare  occurrence,  although 
observed  occasionally.  It  is  characterized  by  a  stiff,  stilty 
gait,  extended  head,  ears  stiffly  erected,  protrusion  of  the 
membrana  nictitans,  skin  wrinkled  over  the  forehead, 
trismus.  The  muscles  of  the  back  and  posterior  limbs  are 
stiff  and  hard;  tail  erected  and  stiff.  The  reflexes  are  greatly 
accelerated  as  shown  when  the  animal  is  touched  or  hears 
sudden  noises.  There  i,s  frequently  opisthotonus,  or  ortho- 
tonus.  Very  characteristic  is  the  facial  expression  of  dogs 
suffering  from  tetanus.  Perhaps  in  the  greater  number  of 
cases  in  dogs  and  birds  tetanus  is  local  and  involves  only 
certain  groups  of  muscles,  usually  the  masseters,  the  muscles 
of  the  ears,  skin  and  muscles  over  the  forehead,  membrana 
nictitans,  and  the  muscles  of  the  neck,  all  of  which  are  con- 
tracted and  the  head  held  fixed.  In  birds  the  symptoms  of 
stiffness  of  the  neck,  wings  held  in  a  fixed  position,  ruffled 
feathers,  stilty  gait  are  the  most  prominent. 

Diagnosis.-  This  is  made  mainly  on   the  characteristic 
symptom  of  tonic  spasms  of  groups  of  muscles,  with  normal 
consciousness  and  temperature,  and  the  subacute  course. 
Differential  Diagnosis.— (a)   Differentiation  must  be  made 


TETANUS— LOCKJAW  615 

between  tetanus  and  strychnin  poisoning  which  show  very 
similar  symptoms.  In  strychnin  poisoning  the  spasms  develop 
more  rapidly,  and  are  of  much  greater  severity  and  the  mem- 
hrana  nictitans  is  not  usually  affected.  .The  extremely  in- 
creased reflex  excitability  in  strychnin  poisoning  as  compared 
to  tetanus  will  also  serve  to  differentiate  them. 

(6)  Tetanus  may  also  be  mistaken  for  cerebrospinal  menin- 
gitis, but  in  the  latter  disease  other  symptoms,  such  as  dulness 
and  paralysis  of  certain  cerebral  nerves,  are  present  which 
will  assist  in  the  diagnosis. 

(c)  Muscular  rheumatism  is  differentiated  by  the  absence 
of  reflex  excitability;  the  muscles  are  painful  and  swollen 
rather  than  contracted  as  in  tetanus. 

(d)  There  are  quite  a  number  of  conditions  (rabies,  eclamp- 
sia, epilepsy,  articular  rheumatism,  etc.)  which  show  some 
symptoms  of  tetanus,  but  there  are  always  other  symptoms 
present  which  are  sufficient  for  differentiation. 

Prognosis.— The  prognosis  in  dogs,  providing  the  symp- 
toms are  localized,  is  quite  favorable.  Should  the  disease, 
however,  become  general  it  is  unfavorable.  The  course  in 
the  dog  is  usually  subacute  or  chronic. 

Treatment.—  Dietetic.— When  trismus  is  present,  prevent- 
ing the  animal  from  taking  food,  rectal  feeding  is  recom- 
mended. Concentrated  beef  broth  at  body  temperature  is 
perhaps  best.  Two  to  four  ounces  should  be  given  3  to  4 
times  daily.  During  the  later  stages  milk  can  be  allowed  as 
they  will  lap  it  in  small  quantities. 

Medical.— Small  and  repeated  doses  of  morphin  sulphate 
(0.05-0.2)  once  or  twice  daily  to  control  spasms  of  the  muscles; 
or  chloral  hydrate  administered  per  rectum  (1  to  4  with  acacia 
and  glycerin),  using  6.0-12.0  of  the  mixture  once  or  twice 
daily.  Subcutaneous  injections  of  a  diluted  carbolic  acid 
solution  have  been  recommended,  but  are  of  doubtful  value. 

Serum. — Tetanus  antitoxin  has  proved  to  be  of  greater 
value  as  a  prophylactic  than  a  curative  treatment.  Large 
doses  might  be  used,  1500  units  daily  for  three  to  four  days. 

Surgical.— In  case  a  wound  is  found  indicating  the  focus 
of  infection,  it  should  be  thoroughly  curetted  and  strong 
antiseptic  solutions  applied  (mercuric  chlorid  1  to  1000; 
carbolic  acid  solution  5  per  cent.). 


CHAPTER   IV. 

CHRONIC  INFECTIOUS  DISEASES. 
TUBERCULOSIS  OF  BIRDS. 

Tuberculosis  Avinm.     Avian  Tuberculosis. 

Definition.— A  chronic  infectious  disease  of  chickens,  ducks, 
pigeons,  parrots  and  .canaries.  It  is  characterized  by  a  slow, 
progressive  emaciation,  which  ends  in  death  from  exhaustion. 

Occurrence.— Avian  tuberculosis  is  a  very  common  disease 
of  chickens  and  parrots.  Occurring  enzootically  among  the 
former,  enormous  losses  to  the  poultrymen  result.  During 
the  past  few  years  it  has  made  its  appearance  in  practically 
all  sections  of  the  United  States.  In  a  number  of  instances 
entire  flocks  of  birds  have  succumbed  to  the  disease,  or 
become  so  infected  and  emaciated  that  their  destruction 
was  necessary.  The  economic  importance  of  the  disease  is 
not  entirely  confined  to  those  that  die  from  the  disease 
directly,  but  it  has  an  important  bearing  on  the  egg  produc- 
tion. 

Etiology.— Tins  disease  is  produced  by  the  Bacillus  tuber- 
culosis avium.  Its  biological  characteristics  are  similar  in 
many  respects  to  the  Bacillus  tuberculosis  of  other  animals 
(mammalian  tuberculosis) . 

Pathogenesis.— The  bacilli,  picked  up  with  the  food,  are 
passed  directly  to  the  intestinal  tract,  where  they  pass 
through  the  lymph  follicles  into  the  intestinal  wall,  either 
to  become  localized  at  this  point,  or  to  pass  into  the  portal 
vein  and  liver.  Or  they  may  gain  access  to  the  general  circu- 
lation and  through  it  become  distributed  to  various  parts 
of  the  body.  It  is  possible  that  the  intestines  may  not 
become  affected  by  the  bacilli  passing  through  the  walls,  but 
in  a  great  many  cases  tubercular  nodules  are  found  in  this 


TUBERCULOSIS  OF  BIRDS  617 

location.  When  the  bacilli  are  taken  into  the  general  circula- 
tion specific  lesions  will  be  found  in  the  spleen,  lungs,  joints, 
etc.  The  large  number  of  nodules  found  in  the  intestinal 
wall  develop  in  most  cases  from  the  infection  following  along 
the  course  of  the  lymph  nodes,  or  from  the  bacilli  becoming 
lodged  between  the  serous  and  muscular  coats  of  the  bowel, 
producing  a  reactive  inflammation  and  the  formation  of 
tubercles.  The  toxic  action  of  -the  chemical  products  of 
the  bacilli  produces  a  gradual  emaciation,  cachexia,  and 
ultimately  death. 

Natural  Infection. — Most  cases  of  tuberculosis  in  fowls  no 
doubt  result  from  eating  foods  contaminated  with  bowel 
discharges  from  affected  birds.  Bacilli  are  found  in  the 
feces  of  affected  birds  in  large  numbers,  particularly  in  those 
cases  where  ulcerations  are  present  on  the  intestinal  mucosa. 
Another  very  common  source  of  infection  is  when  healthy 
birds  eat  the  organs  of  those  that  have  succumbed  to  the 
disease.  Carelessness  in  disposing  of  dead  birds  makes  this 
a  very  common  source  of  infection.  There  is  a  possibility 
of  birds  contracting  the  disease  from  the  fecal  discharges  of 
cattle  affected  with  tuberculosis.  This  is  a  disputed  point 
at  the  present  time.  There  is  considerable  doubt  also  about 
their  contracting  the  disease  from  the  sputum  of  the  human 
subject.  Parrots  seem  to  contract  the  disease  from  this 
source.  Numerous  cases  have  been  recorded  where  fowls 
contracted  tuberculosis,  and  at  the  same  time  the  attendants 
had  the  disease.  Whether  transmission  of  the  disease  is 
brought  about  in  this  way  is  in  dispute.  Flocks  are  usually 
infected  from  newly  acquired  tubercular  birds.  Pigeons  may 
carry  the  disease  from  flock  to  flock. 

Pathology.— The  chief  anatomical  changes  are  found  in  the 
liver,  spleen,  intestines,  joints,  and  in  parrots  in  the  joints, 
and  skin  about  the  head  and  neck.  The  surface  of  the  liver 
is  covered  with  numerous  small  nodules  and  on  cross-section 
they  are  found  to  extend  into  or  through  the  entire  structure. 
Sometimes  the  tubercles  become  confluent  and  form  large 
masses,  white,  gray,  or  grayish-white  in  color,  the  centers  of 
which  are  caseous.  The  liver  is  frequently  much  enlarged, 
very  friable  indicating  fatty  degeneration.  The  spleen  is 


()18  CHRONIC  INFECTIOUS  DISEASES 

similarly  affected.  The  intestinal  lesions  are  very  common, 
and  consist  of  a  large  number  of  small  nodules  found  on  the 
mucosa.  By  confluence  large  areas  appear  as  do  ulcers.  On 
the  serous  coat  of  the  intestines  are  found  nodules  varying 
in  size  from  a  millet  seed  to  a  hazel  nut.  The  mesentery  may 
show  similar  lesions.  The  abdominal  lymph  glands  are 
usually  enlarged  and  caseated.  In  some  cases  on  opening 
the  abdominal  cavity  a  striking  picture  is  presented  as  the 
entire  visceral  peritoneum  is  covered  by  hundreds  of  very 
small  white  or  grayish  nodules.  The  lesions  in  the  lungs  are 
similar,  although  not  usually  so  marked  as  in  the  liver  and 
intestines.  The  affected  joints  are  enlarged,  contain  a  cheesy, 
yellowish  mass  and  the  articular  cartilages  are  eroded.  The 
other  organs  and  tissues  are  not  often  involved,  although 
nodules  are  found  occasionally  in  the  kidneys,  ovaries,  tes- 
ticles, pericardium,  heart  and  gizzard.  In  parrots  the  disease 
is  usually  localized  around  the  head  and  in  the  mouth. 
Xodules  varying  in  size  and  condition  are  found  containing 
the  same  cheesy,  yellowish  material. 

Symptoms.— In  the  early  stages  of  avian  tuberculosis  the 
symptoms  are  very  indefinite.  The  disease  is  chronic  and 
characterized  by  a  gradual  emaciation  without  any  specific 
clinical  symptoms.  The  emaciation  continues  in  spite  of  good 
appetite.  The  appetite  persists  as  a  rule  until  the  beginning 
of  a  general  toxemia,  when  it  diminishes  to  disappear  entirely 
during  the  latter  stages  of  the  disease.  Symptoms  of  anemia 
develop  as  evidenced  by  paleness  of  the  mucous  membranes, 
comb  and  wattles,  dulness,  and  rough  plumage.  During  the 
latter  stage  the  fowls  are  listless,  much  emaciated,  and  show 
all  the  symptoms  of  asthenia.  Diarrhea  sets  in,  and  complete 
exhaustion  is  followed  in  a  few  days  by  death.  There  is  con- 
siderable variation  in  the  period  of  time  required  for  the 
development  of  the  general  symptoms.  When  the  bones  and 
joints  are  affected,  there  is  usually  an  involvement  of  the 
joints  of  the  wings,  and  the  tarsal  joints.  At  first  the  joint 
shows  swelling  which  develops  gradually.  The  swelling  is 
firm  at  first,  but  in  nearly  all  cases  becomes  soft  and  fluctuat- 
ing, and  when  opened  discharges  a  yellow,  caseous  material. 
The  bird  is  lame  and  the  wings  are  held  pendent. 


TUBERCULOSIS  OF  BIRDS  619 

In  some  cases  small  nodules  are  found  beneath  the  skin  on 
various  parts  of  the  body.  Parrots  are  affected  in  the  major- 
ity of  cases  locally  around  the  eyes,  face,  or  on  the  neck,  or 
the  articulations  may  be  involved.  The  lesions  are  small, 
round,  or  oval  nodules  developing  on  some  part  of  the  skin 
or  mucous  membrane.  Later  they  become  caseous.  Their 
characteristics  vary  somewhat,  depending  upon  whether  they 
are  located  in  the  skin,  or  in  the  mucous  membrane  of  the 
mouth.  The  nodules  when  irritated  often  become  quite 
large,  rupture,  and  leave  an  extensive  ulcerous  surface.  When 
the  joints  are  involved  the  same  symptoms  are  observed  as  in 
fowls.  General  symptoms  occur  occasionally  in  parrots. 

Diagnosis.— The  diagnosis  from  the  symptoms  presents 
considerable  difficulty.  However,  when  we  consider  that  a 
number  of  fowls  in  a  flock  are  affected  with  a  disease  causing 
emaciation,  exhaustion  and  death,  we  should  suspect  tuber- 
culosis. Several  methods  of  diagnosis  have  been  recom- 
mended of  which  the  following  have  given  the  best  results: 
(a)  An  affected  bird  is  killed  and  an  autopsy  made.  The 
tubercular  lesions  are  quite  characteristic  and  the  tubercle 
bacilli  may  be  found  under  the  microscope.  (6)  By  use  of 
avian  tuberculin.  This  method  has  been  employed  quite 
extensively  of  late.  It  has  been  found  quite  reliable  in  most 
cases.  The  tuberculin  is  injected,  using  about  0.003  per 
bird,  into  the  deeper  layers  of  the  skin  of  the  comb  or  wattles, 
using  a  small  dental  syringe.  Care  should  be  observed  that 
the  needle  is  not  inserted  too  deeply,  or  the  tuberculin  will 
enter  the  subcutaneous  tissues.  On  the  other  hand,  it  must 
not  be  too  superficial  or  the  epithelial  layer  will  rupture  and 
allow  the  tuberculin  to  escape.  The  reaction  consists  in  a 
rounded  swelling  which  develops  in  twenty-four  to  seventy- 
two  hours  at  the  point  of  injection.  The  degree  of  reaction 
varies  with  individual  cases. 

Differential  Diagnosis. — There  are  several  conditions  which 
might  be  confused  with  avian  tuberculosis,  viz:  (a)  Asthenia 
("  going  light")  which  is  characterized  by  gradual  emaciation, 
and  exhaustion,  but  negative  findings  on  autopsy.  Micro- 
scopic examination  will  aid  in  revealing  the  difference.  (6) 
External  parasites  when  affecting  a  number  of  birds  in  a 


020  CHRONIC  INFECTIOUS  DISEASES 

Hock  will  produce  emaciation  and  a  general  unthrifty  condi- 
tion. Finding  the  parasites  in  large  numbers,  and  negative 
autopsy  will  suffice  for  differentiation.  (c)  Rheumatic 
arthritis,  or  arthritis  urica  may  resemble  joint  tuberculosis. 
In  doubtful  cases  a  microscopic  examination  (tubercle  bacilli) 
may  be  resorted  to. 

Prognosis.  —  Unfavorable. 

Treatment.— Xo  treatment  is  of  any  value  after  the  disease 
has  once  become  established. 

Surgical.— Localized  abscesses  as  they  occur  in  parrots 
should  be  incised  freely,  and  the  contents  thoroughly  removed 
with  a  curette.  Tincture  of  iodin  is  applied  to  abscess 
cavities. 

Prevention.— On  account  of  the  disease  being  difficult  to 
diagnose  until  well  established,  separation  of  the  sick  from 
the  healthy  birds  is  not  feasible.  In  valuable  birds  the 
tuberculin  test  with  segregation  should  be  tried.  Removing 
the  reactors  will  assist  in  controlling  the  disease.  If  this 
cannot  be  done,  it  is  recommended  that  the  entire  flock  be 
killed,  all  diseased  fowls  burned,  and  the  healthy  ones  sold 
for  food.  The  premises  should  be  thoroughly  disinfected, 
buildings,  coops,  etc.,  washed  with  bichlorid  solution  (1  to 
2000).  The  soil  in  the  runs  should  be  saturated  with  liquor 
cresolis  compositus  (3  per  cent.). 

A  new  flock  of  birds  should  not  be  obtained  before  at 
least  six  months  have  elapsed.  Thoroughness  in  the  cleaning 
and  disinfection  is  very  important  if  good  results  are  to  be 
expected. 


TUBERCULOSIS  OF  DOGS  AND  CATS. 

Occurrence  and  Form.— Tuberculosis  is  not  very  often 
observed  in  dogs  and  cats.  As  the  pulmonary  form  is  most 
common,  the  infection  is  probably  transmitted  to  the  lungs 
on  inhaled  particles  of  dust.  In  some  cases,  primary  involve- 
ment of  the  digestive  tract  is  found,  indicating  that  the  germs 
were  probably  taken  in  with  the  food.  Rarely  do  we  find 
infection  has  taken  place  through  any  other  channel. 


TUBERCULOSIS  OF  DOGS  AND  CATS  621 

Pathogenesis.— Most  of  the  cases  no  doubt  result  from 
association  with  tubercular  human  beings,  or  contact  with 
infected  rooms,  etc.  It  may  also  result  from  ingesting  meat 
containing  the  bacilli. 

Pathology.— Two  distinct  types  are  found  on  necropsy: 
(a)  Pulmonary  form,  and  (6)  digestive  form. 

(a)  In  the  pulmonary  form  the  lungs  show  caseous  foci, 
or  small  miliary  nodules.  A  chronic,  indurative  broncho- 
pneumonia  or  a  chronic  interstitial  pneumonia  is  frequently 
found.  Adhesions  are  common  between  the  lungs  and 
parietal  pleura.  Aside  from  these  lesions  there  are  very  often 
present  edema  and  emphysema  of  the  lungs,  bronchitis  and 
bronchiectasis.  The  pleura  often  shows  evidence  of  a  serous 
or  serofibrinous  pleuritis  with  considerable  fluid  present  in  the 
thoracic  cavity;  or  in  other  cases  a  dry,  granular  adhesive 
pleuritis  in  which  the  parietal  and  visceral  pleura  are  adherent. 
Numerous  small  nodules  are  often  found  on  the  pleura.  The 
bronchial  lymph  glands  are  more  or  less  enlarged. 

(6)  The  intestinal  lesions  are  mainly  in  the  mesenteric 
lymph  glands,  which  are  enlarged;  the  walls  of  the  intestines 
show  miliary  tuberculosis,  particularly  on  the  serous  covering; 
the  liver  usually  presents  similar  lesions.  The  spleen  and 
kidneys  often  show  miliary  tuberculosis.  The  cadaver  in 
general  shows  evidence  of  cachexia  and  emaciation. 

Symptoms.— The  disease  usually  runs  a  chronic  course  the 
symptoms  developing  gradually.  General  emaciation  is 
apparent  in  spite  of  a  fairly  good  appetite,  the  animals  become 
easily  exhausted,  are  dyspneic  (lung  form),  and  weak.  After 
emaciation  begins  to  be  a  prominent  symptom,  the  form  of  the 
disease,  whether  pulmonary  or  intestinal,  will  assert  itself. 
The  pulmonary  form  is  characterized  by  a  short,  dry  cough, 
which  later  becomes  moister  and  is  accompanied  by  a  dis- 
charge of  a  mucopurulent  secretion  which  in  most  cases  is 
swallowed.  The  respirations  grow  labored;  dry  or  moist 
rales  are  heard  on  ausculation.  Percussion  reveals  areas  of 
flatness,  and  usually  hydrothorax.  An  atypical  fever  is 
present  during  the  course  of  the  disease.  In  the  intestinal 
form  the  symptoms  of  chronic  intestinal  catarrh  are  most 


622  CHRONIC  INFECTIOUS  DISEASES 

prominent  with  diarrhea  during  the  latter  stages.  Rapid 
emaciation  is  generally  followed  by  death  in  a  short  time. 

Diagnosis.— As  tuberculosis  is  not  very  common  in  dogs 
and  cats,  and  the  symptoms  not  particularly  characteristic, 
a  diagnosis  is  not  often  made  during  life.  The  history  of  the 
case  and  its  chronicity  might  lead  one  to  suspect  it.  Tuber- 
culin (0.15  to  0.20)  might  be  used  subcutaneously.  The 
reaction  is  more  prompt  but  the  test  is  not  so  reliable  as  in 
large  animals. 

Prognosis. —Unfavorable. 

Treatment.— In  advanced  cases  no  treatment  should  be 
attempted.  During  the  early  stages  good  nutritious  food, 
and  tonics  are  best.  Inhalations  'of  creolin  vapor  are  recom- 
mendablc. 

GLANDERS. 

In  dogs  and  cats  glanders  is  not  very  common.  It  is  occa- 
sionally observed  among  carnivora  fed  meat  or  organs  from 
horses  affected  with  glanders.  In  zoological  gardens  glanders 
may  be  enzootic  among  meat  eating  animals,  especially 
when  horse  meat  is  fed.  Glanders  usually  assumes  an  acute 
form  in  these  animals.  The  early  symptoms  are  those  of  an 
intense  inflammation  of  the  mucous  membrane  of  the  nasal 
passages,  larynx,  trachea,  and  the  conjunctiva.  In  a  short 
time  (two  to  five  days)  appears  a  greenish-gray  or  blood- 
stained secretion  from  the  eyes  and  nose.  The  respirations 
are  labored  on  account  of  the  intense  congestion  and  swell- 
ing of  the  respiratory  mucous  membrane.  The  symptoms 
rapidly  become  aggravated,  the  tissues  about  the  head 
become  swollen,  nodules  appear  at  different  points  in  the 
skin,  which  open  and  form  irregular  shaped  ulcers.  Diarrhea 
is  a  prominent  symptom.  The  animal  becomes  emaciated, 
and  succumbs  in  the  course  of  eight  to  fourteen  days.  When 
such  symptoms  occur,  the  animal  should  be  isolated  so  that 
further  spread  of  the  disease  is  controlled.  Thorough  dis- 
infection of  the  premises,  and  proper  disposition  of  the 
cadavers  are  very  important. 


PSEUDO-ACTINOMYCOSIS  OF  DOGS  623 

PSEUDO-ACTINOMYCOSIS  OF  DOGS. 

Streptotrichosu  Canum.     Actinomyces  Canis. 

Definition.— A  specific  disease,  caused  by  the  Actinomyces 
canis,  cliaracterized  by  an  inflammation  of  serous  mem- 
branes, and  abscess  formation  of  the  subcutaneous  tissues. 

Occurrence.— This  disease  is  not  of  frequent  occurrence  in 
dogs.  A  few  cases  have  also  been  noted  in  cats. 

Etiology.— The  specific  virus,  Actinomyces  canis,  produces 
long  divided  filaments,  which  are  easily  stained  by  the  Gram- 
Weigert  method.  Sometimes  they  form  club-shaped  bodies. 
On  artificial  media  the  fungus  grows  at  the  body  temperature. 

Pathogenicity.  —  When  pure  cultures  are  injected  intra- 
peritoneally  into  mice,  they  produce  at  the  point  of  inoculation 
nodules  of  varying  size  (pea  to  bean)  containing  pus.  Sub- 
cutaneous injections  into  rabbits  cause  at  the  point  of  injec- 
tion nodules  which  form  abscesses.  The  same  condition  may 
be  produced  in  dogs  by  subcutaneous  injections. 

Pathology.— The  lesions  usually  found  are  in  the  pleura  or 
peritoneum.  They  consist  of  an  exudate  of  reddish  color 
collected  in  the  body  cavity,  containing  numerous  small, 
white,  pin-point  nodes.  On  the  serous  membrane  will  be  a 
number  of  small  nodules,  and  on  the  pleura  fibrinous  exudate. 
The  lungs  often  contain  a  number  of  pea-sized  nodes  with 
caseous  centers. 

Abscess  formation  occurs  in  different  parts  of  the  body, 
particularly  in  the  subparotid  region,  the  vagina,  or  in  the 
subperitoneal  connective  tissue  of  the  pelvis.  The  abscesses 
contain  a  grayish  turbid  mass  in  which  are  many  of  the 
characteristic  granules.  The  abscesses  usually  heal  after 
discharging  their  contents.  The  spleen,  kidneys  and  heart 
muscles  often  show  nodular  lesions.  Arthritis  with  pus 
formation  is  seen  in  some  cases. 

Symptoms.— The  disease  during  the  early  stages  does  not 
present  any  characteristic  symptoms.  Later,  however, 
there  will  be  evidence  of  chronic  inflammation  of  the  serous 
membranes  with  collections  of  fluid  in  the  thoracic  and 
abdominal  cavities.  As  the  disease  progresses,  the  animal 
shows  general  emaciation,  weakness,  and  the  presence  of 


024  CHRONIC  INFECTIOUS  DISEASES 

abscesses  in  various  parts  of  the  body.  The  inflammation 
of  the  lungs  develops  gradually  and  is  not  attended  by  any 
marked  change  in  temperature.  Dyspnea  is  a  prominent 
symptom.  The  animal  gradually  grows  weaker  and  dies  from 
exhaustion. 

Diagnosis. -The  diagnosis  is  established  only  after  rinding 
the  characteristic  granules  or  filaments  in  the  discharge  from 
the  abscesses.  The  symptoms  alone  would  not  be  sufficient 
for  an  accurate  diagnosis. 

Prognosis.  — When  the  disease  shows  evidence  of  general 
involvement  of  the  body,  the  prognosis  is  unfavorable.  More 
favorable  are  those  cases  of  localized  infection. 

Treatment.— Abscesses  should  be  opened,  drained,  and  the 
cavity  painted  with  tincture  of  iodin.  Potassium  iodid  (dog 
0.05  0.15;  cat  0.00.5-0.05)  given  once  daily  is  recommended. 
Xo  further  treatment  would  be  of  any  value. 


CHAPTER  V. 

INFECTIOUS  DISEASES  PRODUCED  BY 
PROTOZOA. 

SPIROCKffiTOSIS  OF  FOWLS. 

Spirochcetosis  Avium.     Spirillosis  of  Chickens. 

Definition.— A  fatal  septicemia  of  chickens,  ducks,  geese, 
and  pigeons. 

Occurrence.— This  disease  has  made  its  appearance  in 
several  countries  in  enzootic  form.  A  few  outbreaks  have 
been  observed  in  the  southern  part  of  the  United  States. 
Up  to  the  present  time  the  disease  has  not  attained  economic 
importance  in  this  country.  It  occurs  most  commonly  in 
chickens  where  it  seriously  interferes  with  breeding. 

Etiology.— The  Spirochaete  gallinarum  (Spirillum  anserum) 
is  now  recognized  as  the  causative  agent.  This  is  a  blood 
parasite,  probably  a  flagellated  protozoon.  It  appears  as 
fine  threads,  10  to  20  microns  long,  spirally  formed,  and 
provided  with  one  or  more  cilia  which  show  active  move- 
ments. These  parasites  leave  the  blood  rapidly  after  the 
fowl's  death. 

Pathogenesis.— The  disease  is  easily  produced  by  injections 
of  virulent  blood  from  one  fowl  to  another  of  the  same 
species.  Older  fowls  are  less  susceptible  than  younger  ones. 
The  disease  develops  rapidly  following  inoculation.  After 
the  second  day  larger  numbers  of  the  spirilla  are  found  in  the 
blood. 

Natural  Infection.— The  disease  is  transmitted  by  ticks; 
mainly  by  the  Argas  miniatus,  in  some  cases  by  the  Argas 
persicus  and  Argas  reflexus,  and  in  others  by  the  Ornitho- 
dorus  moubata.  The  ticks  exist  in  waste  places  or  in  wooded 
districts.  Fowls  become  infested  by  roosting  where  the  ticks 
occur.  The  ticks  attach  themselves  to  the  body,  and  suck 
40 


626     INFECTIOUS  DISEASES  PRODUCED  BY  PROTOZOA 

its  blood,  thus  directly  inoculating  the  fowl.    The  spirillee 
are  soon  found  in  the  blood. 

Pathology.— The  most  characteristic  lesions  on  necropsy 
are  enlarged  spleen  and  liver,  both  organs  showing  numerous 
areas  of  degeneration  and  necrosis.  The  heart  muscle  shows 
evidence  of  inflammation.  No  other  lesions  of  importance  are 
found. 

Symptoms.— The  period  of  incubation  is  from  eight  to  ten 
days.  Some  cases  develop  in  four  to  six  days  after  the  ticks 
have  been  placed  on  the  fowl.  The  early  symptoms  are  those 
of  suppression  of  appetite,  high  temperature  (108°-111°  F.), 
somnolence,  weakness.  Later  diarrhea  sets  in;  the  comb  and 
wattles  become  bluish-red;  marked  weakness  and  paralysis. 
During  the  later  stages  of  the  disease  the  temperature 
becomes  normal  or  subnormal.  Death  follows  in  a  short 
time  in  most  cases  under  symptoms  of  convulsions  and  para- 
lysis. The  majority  of  cases  are  acute;  a  few  have  been 
observed  to  assume  a  chronic  type.  The  course  of  the  disease 
is  usually  from  four  to  six  days  in  the  acute  form  and  ten  to 
eighteen  days  in  the  chronic. 

Diagnosis.— This  is  made  by  noting  the  enzootic  character 
of  the  disease;  the  characteristic  lesions  on  autopsy,  and  the 
finding  of  the  Spirochaetes  in  the  blood  of  sick  birds. 

Prognosis.— The  prognosis  is  unfavorable  when  the  disease 
is  well  established.  Some  cases  recover. 

Treatment.  — Atoxyl  (0.1  peroremfortwo  consecutive  doses) 
has  been  recommended,  and  has  proved  to  be  highly  efficient 
in  producing  immunity  from  infection  in  normal  fowls. 
Atoxyl  (0.05)  as  an  intramuscular  injection  is  recommended 
for  infected  birds.  In  two  to  three  days  the  parasites  dis- 
appear from  the  blood.  Atoxylate  of  mercury  has  also  been 
used  in  a  similar  manner.  This  treatment  when  properly 
administered  will  produce  excellent  results. 

Immunization  of  fowls  with  the  blood  of  sick  chickens, 
which  has  been  allowed  to  stand  for  forty-eight  hours,  has 
proved  of  great  value.  After  this  period  the  blood  is  no 
longer  infectious  and  may  be  injected  subcutaneously  into 
healthy  fowls.  This  establishes  an  immunity  against  infec- 
tion. 


ENTEROHEPATITIS  G27 

A  horse  serum  has  been  produced  (by  hyperimmunization 
of  the  horse  with  repeated  injections  of  live  spirillse).  In 
doses  of  3  to  5  c.c.  per  bird  it  has  given  good  results.  Immun- 
ization of  the  flock  by  this  method  would  be  recommended  as 
early  as  possible. 

ENTEROHEPATITIS. 

Blackhead. 

Definition.— A  disease  peculiar  to  turkeys.  It  is  occa- 
sionally observed  in  other  birds,  particularly  chickens. 

Occurrence.— Blackhead  is  very  prevalent  in  various  sec- 
tions of  the  United  States,  occurring  often  in  an  enzootic 
form  destroying  whole  flocks,  and  seriously  interfering  with 
the  raising  of  turkeys  in  many  districts.  It  is  especially 
fatal  in  young  birds. 

Etiology.— It  is  produced  by  a  protozoon,  Amoeba  melea- 
gridis.  This  parasite  is  microscopic  in  size  and  is  found  in  large 
numbers  in  the  liver,  ceca  and  other  portions  of  the  intes- 
tinal tract.  Some  authorities  claim  that  a  coccidium  is  the 
cause  of  the  disease.  When  coccidia  are  present,  however, 
the  above  parasite  also  coexists  which  makes  it  probable 
that  the  amoeba  rather  than  the  coccidia  cause  the  disease. 

Pathogenesis.— Blackhead  is  spread  by  the  bowel  discharges 
of  the  affected  birds  which  contain  the  parasites  in  large 
numbers.  Food  and  water  polluted  with  infested  fecal 
matter  are  taken  into  the  digestive  tract  of  well  birds.  When 
the  amoeba  reach  the  intestinal  tract  they  develop  rapidly, 
producing  irritation  to  the  mucosa  and  ultimately  lead  to  a 
marked  inflammation.  The  liver  as  a  rule  is  invaded  during 
the  progress  of  the  disease  showing  intense  hepatitis.  The 
parasites  may  enter  the  liver  via  the  lymphatic  system  or 
directly  through  the  bile  duct.  Intermediate  agents  (other 
birds,  sparrows,  pigeons,  etc.)  are  often  responsible  for  the 
transmission  of  the  disease  to  other  flocks. 

Necropsy.— The  autopsy  findings  are  confined  mostly  to 
the  liver  and  intestines.  The  liver  is  found  much  enlarged 
(often  three  to  four  times  normal),  the  surface  studded  with 
whitish  or  yellowish  spots,  which  when  opened  show  degener- 


028     INFECTIOUS  DISEASES  PRODUCED  BY  PROTOZOA 

ated  areas  filled  with  a  soft  caseated  material.  On  cross- 
section  the  liver  will  show  darkened  spots  often  surrounded 
by  degenerated  areas,  giving  it  a  peculiar  spotted  or  marbled 
appearance.  The  organ  is  soft,  friable,  easily  crushed  between 
the  fingers.  The  infection  produces  a  more  or  less  rapid 
necrosis  of  the  entire  liver  substance.  The  ceca  are  much 
enlarged  and  the  mucosa  swollen;  later  cases  show  ulceration 
and  degeneration  of  the  membrane.  Chronic  cases  exhibit 
extensive  ulcerations  on  various  portions  of  the  mucosa. 
The  fecal  matter  in  the  lower  bowels  is  mixed  with  blood, 
giving  it  a  dark  tarry  appearance.  The  serous  membranes 
(pericardium,  pleura,  peritoneum,  etc.)  show  evidence  of 
inflammation  and  effusion  of  fluid.  The  cavities  (thoracic 
and  abdominal)  may  be  partially  filled  with  exudate.  In 
chronic  cases  dropsical  swellings  are  often  found  in  the 
cavities  and  extremities. 

Symptoms.— The  disease  is  most  often  observed  in  young 
turkeys,  although  in  some  outbreaks  older  birds  are  affected. 
The  early  indications  of  the  disease  are  purplish  discoloration 
of  the  comb  and  wattles,  dulness,  rough  plumage,  drooping 
of  the  tail  and  wings,  complete  loss  of  appetite  in  most  cases, 
and  a  tendency  for  the  bird  to  remain  in  a  sitting  posture  for 
long  periods.  During  this  period  there  is  nearly  always  a 
severe  diarrhea.  The  discharges,  being  greenish-yellow  in 
color,  have  a  very  offensive  odor.  The  birds  gradually  grow 
weaker  and  become  exhausted  in  a  few  days.  Death  occurs 
in  most  cases  in  three  to  five  days.  In  less  severe,  or  chronic 
cases,  the  birds  lose  their  appetite  or  it  becomes  irregular, 
and  they  gradually  grow  emaciated  and  weak.  Some  cases 
will  partially  recover,  and  the  bird  will  droop  around  for 
several  weeks.  Other  cases  recover  completely  from  the 
disease. 

Diagnosis.— This  is  made  by  considering  the  enzootic 
character  of  the  disease,  its  symptoms,  and  autopsy  findings. 
There  is  no  other  disease  common  to  turkeys  producing  such 
serious  losses.  Whenever  the  disease  is  suspected  a  micro- 
scopic examination  should  be  made  of  the  discharges  and 
cecal  contents. 


INFECTIOUS  DIARRHEA  OF  CHICKS  629 

Prognosis.— Owing  to  the  high  mortality  of  the  disease  the 
prognosis  is  unfavorable.  Its  rapid  spread  from  one  bird 
to  another,  and  to  other  flocks,  makes  the  disease  difficult 
to  control.  The  mortality  may  reach  from  50  to  90  per  cent. 

Treatment.— Intestinal  antiseptics  are  indicated.  Sodium 
sulphocarbolate  (0.2-0.4)  two  or  three  times  daily  has 
given  good  results.  Also  salol  in  the  same  doses.  Admin- 
ister sulphate  of  iron  in  the  drinking  water,  using  one  ounce 
of  the  sulphate  of  iron  to  one  gallon  of  water.  This  has 
proved  to  be  of  value  as  a  bowel  disinfectant.  As  soon  as 
an  outbreak  appears,  radical  means  should  be  adopted  at 
once  to  prevent  the  spread  of  the  disease.  Disinfect  the 
coops  and  houses  thoroughly  with  lysol  solution  (3  per  cent.), 
or  lime  solution.  Clean  up.  all  droppings  two  or  three  times 
daily  and  either  burn  them  or  bury  in  lime.  Disinfect  all 
drinking  fountains  and  feed  pans  daily.  Extreme  care  must 
be  used  by  attendants  to  prevent  carrying  the  infection  to 
other  birds  or  flocks.  Good  results  often  follow  when  these 
details  are  carried  out  conscientiously. 

INFECTIOUS  DIARRHEA  OF  CHICKS. 

White  Diarrhea. 

Definition.— An  infectious  disease  affecting  young  chicks, 
characterized  by  a  severe  diarrhea,  prostration  and  high 
mortality.  Owing  to  the  fact  that  it  affects  chicks  shortly 
after  being  hatched,  and  such  large  numbers  die,  it  is 
one  of  the  most  important  diseases  with  which  the  poultry- 
man  has  to  contend.  The  losses  to  the  poultry  industry 
through  its  ravages  are  enormous.  In  some  districts  it  is 
becoming  very  difficult  to  rear  young  chicks. 

Etiology.— It  is  necessary  to  recognize  two  distinct  etiolog- 
ical  factors,  viz:  (a)  A  form  produced  by  the  Bacterium 
pullorum,  and  (6)  a  protozoal  form  caused  by  the  Coccidium 
tenellum.  Both  of  these  forms  are  frequently  met  with  in 
practice.  The  reason  the  conditions  should  be  classified 
together  is  because  they  appear  in  the  same  aged  birds, 
produce  much  the  same  symptoms,  and  it  has  been  found 


630     INFECTIOUS  DISEASES  PRODUCED  BY  PROTOZOA 

that  the  two  diseases  often  coexist  in  the  same  chick.  It  is 
necessary  to  differentiate  the  two  conditions  by  examination 
of  the  cecal  contents  for  the  coccidia,  or  the  liver,  spleen  and 
kidneys  for  the  bacterium. 

Necropsy.— In  the  form  produced  by  the  Bacterium  pul- 
lorum  the  principal  lesions  are  found  in  the  liver,  kidneys, 
spleen  and  intestinal  tract.  The  liver  shows  areas  of  conges- 
tion and  fatty  degeneration.  The  kidneys  are  usually  normal 
in  size  but  show  some  evidence  of  congestion  and  cloudy 
swelling.  The  involvement  of  the  intestinal  tract  is  as  a  rule 
of  minor  importance.  Therefore,  but  slight  changes  are 
found  in  the  majority  of  cases.  The  other  tissues  in  the  body 
are  pale,  anemic  and  show  evidence  of  emaciation.  In  the 
form  produced  by  the  Coccidium  tenellum,  the  most  promi- 
nent lesions  will  be  present  in  the  intestinal  tract.  The  mucosa 
is  congested  and  distinct  ulcerations  are  usually  present  in 
the  ceca.  The  liver,  kidneys  and  musculature  show  similar 
changes  as  found  in  the  other  form.  The  intestinal  contents 
indicate  partial  or  complete  loss  in  function. 

Pathogenesis.  — In  the  bacillary  form  it  is  quite  evident 
that  the  eggs  are  frequently  contaminated  in  their  formative 
stage.  \Vhen  hatched  the  infection  is  already  present  in  the 
chick.  This  no  doubt  accounts  for  the  large  number  of  chicks 
that  succumb  to  the  disease  so  soon  after  they  are  hatched. 
This  mode  of  infection  is  explained  by  the  fact  that  the  laying 
hens  carry  the  infection  in  some  of  the  organs,  probably  the 
ovaries,  which  permit  the  organisms  to  pass  to  the  eggs 
during  the  early  stage  of  their  development.  The  bacilli 
have  been  found  in  the  yolks  of  eggs.  It  is  quite  possible 
to  have  other  modes  of  transmission  of  the  infection,  such 
as  the  infection  being  carried  on  the  outside  of  the  egg  shell 
and  when  the  bird  is  liberated  it  becomes  infected.  Many 
cases  are  infected  from  the  water,  feed,  or  discharges  from 
the  diseased  chicks.  The  infection,  when  introduced  into 
the  delicate  digestive  tract  of  the  chick,  develops  rapidly 
and  interferes  with  the  early  digestion  of  the  food.  Natu- 
rally assimilation  is  practically  stopped  and  the  bird  rapidly 
becomes  weak  and  emaciated.  It  has  been  proved  that 
during  the  first  few  days  of  the  chick's  life  its  principal 


INFECTIOUS  DIARRHEA  OF  CHICKS  631 

source  of  food  supply  is  from  the  yolk  of  the  egg  from  which 
it  is  hatched.  The  infection  is  carried  to  the  other  organs  by 
the  blood  or  lymph  systems. 

The  coccidial  form  develops  in  a  similar  manner.  Numer- 
ous examinations  have  proved  that  laying  hens  are  often 
chronic  carriers  of  the  coccidia  which  are  passed  out  either 
with  the  eggs,  or  with  the  discharges.  The  food,  water,  litter, 
etc.,  are  contaminated  and  therefore  easily  picked  up  by  the 
chick  during  the  first  week  or  ten  days  of  its  life.  The 
coccidia,  when  introduced  into  the  digestive  tract,  develop 
in  a  few  hours  and  penetrate  into  the  mucosa  which  accounts 
for  the  digestive  disturbances.  Both  forms  of  the  disease 
result  in  intestinal  irritation,  congestion,  and  disturbed 
function. 

Symptoms.— The  early  indication  of  the  disease  is  the 
presence  of  a  whitish,  or  whitish-brown,  frothy  discharge 
from  the  bowels.  Examination  of  the  chick  reveals  the  soft, 
pasty  mass  adhering  around  the  cloaca  and  on  the  feathers. 
They  are  dull,  wings  held  pendent,  head  held  down  and  more 
or  less  constantly  emitting  a  peculiar  "peeping"  sound. 
The  appetite  is  suppressed  or  entirely  lost.  The  chicks 
rapidly  become  weak,  often  fall  down  when  urged  to  move, 
and  show  every  evidence  of  general  cachexia.  Death  follows 
often  in  a  few  days  following  hatching.  Other  cases  when 
infected  later  often  are  normal  during  the  first  few  days  or 
week  only  to  take  the  disease  in  two  to  four  weeks,  showing 
practically  the  same  symptoms.  The  mortality  is  50  to  90 
per  cent,  of  the  hatch.  In  order  to  determine  the  presence 
of  the  bacilli  or  coccidia,  a  microscopic  examination  should 
be  made  of  the  discharges,  cecal  contents,  or  cultures  taken 
from  the  organs. 

Diagnosis. — This  is  not  considered  difficult  as  the  disease 
makes  its  appearance  soon  after  the  chicks  are  hatched,  and 
the  fact  that  a  number  of  them  are  affected  at  the  same  time. 
The  symptoms  are  also  quite  characteristic.  There  is  no 
similar  disease  aft'ecting  young  chicks  at  this  age,  except 
possibly  ptomain  poisoning.  A  microscopic  examination  will 
assist  in  making  the  diagnosis. 


632     INFECTIOUS  DISEASES  PRODUCED  BY  PROTOZOA 

Prognosis.— Due  to  the  character  of  the  disease  and  the 
high  mortality  the  prognosis  is  unfavorable.  It  will  depend 
to  some  extent  on  the  age  of  the  chicks  and  the  virulency 
of  the  infection. 

Treatment.—  Dietetic.—  Withhold  all  food  from  the  chicks 
during  the  first  two  or  three  days.  They  have  sufficient  food 
from  the  yolk  of  the  egg  to  sustain  them  for  this  period. 
Afterward  feed  small  amounts  of  egg  yolk,  or  bread  and  milk. 
Buttermilk  or  sour  milk  is  highly  recommended  on  account 
of  the  acid  it  contains  producing  antiseptic  action  on  the 
bowel  contents.  A  small  amount  of  lactic  acid  added  to 
sweet  milk  will  have  a  similar  action.  Buttermilk  tablets  are 
recommended  so  that  a  uniform  quantity  of  sour  milk  may 
be  kept  for  their  use  daily.  These  when  added  to  sweet  milk 
bring  about  sufficient  fermentation  in  twelve  to  twenty-four 
hours.  It  is  quite  important  that  they  do  not  receive  too 
much  food  during  the  first  week  to  bring  on  digestive  dis- 
turbances, thereby  lowering  the  natural  resistance  of  the 
chick. 

Medical.— Zinc  sulphocarbolate  or  sodium  sulphocarbo- 
late  has  given  excellent  results.  It  is  best  given  by  dissolving 
the  preparation  in  water  and  allowing  the  chicks  to  drink 
of  the  solution  freely.  Each  chick  should  receive  from  three 
to  five  grains  of  the  compound  one  or  twice  daily.  When  the 
diarrhea  is  severe  iron  sulphate  in  the  drinking  water  (30.0 
to  4000.0)  is  beneficial  as  an  antiseptic  and  astringent. 

In  the  coccidial  form  the  following  formula  is  highly 
recommended : 

3 — Potassi  dichromate 12.0 

Water    .  250.0 

Misco  et  fiat  solutio. 

N'K- — Use  one  teaspoonful  to  1  quart  of  water  for  chicks  one  week  old. 
YounRcr  chicks  half  the  quantity.  Allow  them  to  drink  of  this  solution 
freely. 

Prevention.— Much  can  be  done  to  prevent  the  disease 
developing  in  young  chicks:  (a)  All  incubators  should  be 
thoroughly  disinfected  by  washing  all  parts  of  them  with  a 
liquor  cresolis  compositus  solution  (3  per  cent.).  Allow  them 
to  dry  out  thoroughly  before  using.  Another  very  effective 


PIROPLASMOSIS  OF  THE  DOG  633 

method  is  to  close  them  up  tight  and  introduce  formaldehyd 
gas.  Incubators  have  proved  to  be  common  carriers  of  the 
infection,  therefore  attention  to  this  matter  is  especially 
important.  (6)  All  eggs  selected  for  hatching  should  be 
cleaned  and  disinfected  in  the  following  manner:  Saturate 
a  cloth  in  50  per  cent,  alcohol  and  wipe  each  egg  carefully 
before  placing  it  in  the  incubator.  Do  not  use  an  excess  of 
alcohol  as  it  will  penetrate  the  egg  shell.  This  treatment 
will  effectively  remove  all  surface  infection,  (c)  All  coops, 
houses,  nests,  etc.,  should  be  disinfected  at  regular  intervals. 
(d)  When  possible  it  would  be  advisable  to  select  hens  as 
layers  that  are  free  from  the  disease.  This  can  be  done  quite 
efficiently  by  examining  samples  of  eggs,  discharges,  aggluti- 
nation test,  etc.  (e)  All  litter  from  infected  houses,  coops, 
etc.,  should  either  be  burned  or  treated  with  lime  to  pre- 
vent the  perpetuation  of  the  disease. 

PIROPLASMOSIS  OF  THE  DOG. 

Infectious  Jaundice.     Biliary  Fever.     Malignant  Jaundice. 

Definition.— A  malignant  or  infectious  disease  of  the  dog 
produced  by  the  Piroplasma  canis  or  Piroplasma  commune. 

Etiology.— Piroplasmosis  of  the  dog  has  been  reported  in 
several  different  countries.  It  is  produced  by  two  species  of 
piroplasma  or  Babesia:  Piroplasma  canis  and  Piroplasma 
commune.  Morphologically  these  parasites  are  identical 
with  Piroplasma  bigeminum.  The  Piroplasma  canis  is  2-4 
microns  in  diameter,  the  free  organisms  spherical,  and  those 
contained  within  the  corpuscles  are  pear-shaped  or  contain 
many  angles.  Multiplication  is  by  direct  division.  The 
Piroplasma  commune  is  similar,  round  or  pear-shaped.  The 
round  type  is  1.0-1.5  microns,  and  the  pear-shaped  1.5-2.5 
microns  in  diameter.  The  former  is  not  transmissible  to  any 
other  animal  while  the  latter  has  been  transmitted  to  the 
guinea  pig  and  cat. 

Dogs  become  infected  from  ticks  and  fleas  (Ixodes  ricinus, 
Rhipicephalus  sanguineus,  Dermacentor  variabilis,  Haema- 
physalis  Leachi,  Ctenocephalus canis),  which  have  been  found 
to  be  common  carriers  of  the  disease.  Young  animals 


034     INFECTIOUS  DISEASES  PRODUCED   BY   PROTOZOA 

(puppies)  are  most  susceptible  and  often  an  entire  litter  will 
develop  the  disease.  Older  animals  are  partially  or  com- 
pletely immune.  The  disease  may  be  readily  transmitted 
by  injecting  young  animals  with  virulent  blood.  The  initial 
symptoms  develop  in  two  to  three  days.  Natural  infection 
takes  place  from  animals  coming  in  contact  with  fleas  or 
ticks  infested  with  the  piroplasm.  The  period  of  incubation 
from  natural  infection  is  from  seven  to  ten  days. 

Pathology.— In  the  acute  form  the  disease  process  is  often 
so  rapid  that  but  little  will  be  found  on  postmortem  examina- 
tion. The  liver  is  found  congested,  the  bile  of  dark  color  and 
thick.  The  spleen  is  enlarged  often  two  or  three  times  its 
normal  size;  the  color  is  dark,  the  borders  rounded.  The 
kidneys  are  congested,  and  small  hemorrhages  are  noted  on 
the  surface.  The  heart  muscle  is  pale,  and  small  petechise 
and  ecchymoses  are  observed  on  the  endo-  and  epicardium. 
The  lungs  are  usually  edematous,  and  ecchymoses  occur  on 
the  membranes.  The  bladder  contains  a  reddish-brown 
colored  urine,  especially  in  the  very  acute  form  of  the  disease. 
The  skin  and  mucous  membranes  are  greenish  in  color,  which 
in  some  cases  may  be  absent,  the  membranes  very  pale  and 
anemic.  In  the  chronic  form  the  postmortem  lesions  are 
those  of  an  anemia,  with  a  paleness  of  all  the  tissues  and 
organs.  The  liver  is  found  intensely  congested,  the  bile  of  a 
syrupy  consistency  and  very  dark  in  color.  The  blood 
from  the  spleen  will  contain  large  numbers  of  the  parasites. 
The  kidneys,  heart  and  lungs  are  congested  and  show  num- 
erous small  hemorrhages  on  their  surfaces.  The  marrow 
of  the  bones  is  intensely  congested,  and  of  a  dark  reddish 
color.  In  the  chronic  form  icteric  symptoms  are  also 
observed.  The  blood  has  a  thin,  watery  appearance,  the 
serum  practically  colorless. 

Symptoms.— The  initial  symptoms  of  the  acute  form  are 
those  of  a  severe  infectious  disease:  Depression,  loss  of 
appetite,  often  severe  vomiting.  Paralysis  of  the  posterior 
extremities  often  takes  place  early  (in  eighteen  to  twenty- 
four  hours)  and  ascends  rapidly  producing  a  general 
paralysis  in  three  to  four  days.  In  the  more  subacute  form 
the  symptoms  are  less  pronounced,  presenting  all  the  evi- 


PIROPLASMOSIS  OF  THE  DOG  635 

deuces  of  an  acute  anemia,  the  mucous  membranes  becoming 
pale,  colorless,  or  bluish.  The  most  common  change -in  the 
mucous  membranes,  however,  is  icteric  discoloration.  A 
characteristic  symptom  is  the  blood  coloring  matter  in  the 
urine,  which  turns  it  pale  red  or  reddish-brown.  The  hemo- 
globin found  in  the  urine  is  rather  high  (5  per  cent.).  The 
temperature  in  the  early  stages  is  elevated  (103°-105°  F.). 
It  remains  elevated  usually  for  twenty-four  to  forty-eight 
hours,  when  it  drops  suddenly  and  becomes  subnormal.  In 
young  dogs  the  temperature  drops  very  rapidly,  as  low  as 
95°-96°  F.  The  pulse  is  increased,  weak  and  wiry;  the 
respirations  36  to  60  and  often  labored. 

The  blood  is  thin  and  paler  than  normal.  The  number  of 
the  red  corpuscles  is  greatly  reduced  (from  5-7  million  to 
2  million  per  c.),  the  white  corpuscles  greatly  increased 
(from  6-7000  to  40,000  per  c.). 

In  the  chronic  form  the  symptoms  are  less  pronounced. 
There  are  evidences  of  anemia,  the  animals  become  weak 
and  indifferent  to  their  surroundings.  The  mucous  mem- 
branes are  usually  pale  or  yellowish,  and  sometimes  of  a 
bluish  color.  The  urine  contains  blood-coloring  matter, 
which  seems  to  be  a  constant  symptom.  The  blood  when 
examined  will  be  found  to  have  a  great  reduction  in  the 
number  of  red  corpuscles,  but  less  than  in  the  acute  form, 
and  the  white  corpuscles  are  about  in  the  same  ratio  as  in 
the  acute  form.  Most  of  the  white  corpuscles  are  found  to 
be  polynuclear,  and  are  often  almost  completely  filled  with 
the  parasites.  The  course  in  this  form  may  be  long,  lasting 
for  days  or  weeks,  the  animals  gradually  recovering  or  dying 
of  marasmus. 

Diagnosis.— The  diagnosis  is  made ^by  carefully  observing 
the  symptoms,  the  fact  that  the  disease  occurs  in  several 
animals  at  the  same  time,  and  the  microscopic  examination 
of  the  blood  to  determine  the  ratio  between  the  red  and  white 
corpuscles,  and  the  presence  of  the  specific  parasite.  Some- 
times it  is  difficult  to  find  the  parasite  from  a  clinical  case 
under  the  microscope.  In  such  cases  it  is  of  advantage  to 
confirm  the  diagnosis  by  inoculating  a  young  puppy  with 
some  of  the  blood  of  the  affected  animal.  The  virulent 


f>3()      INFECTIOUS  DISEASES  PRODUCED  BY  PROTOZOA 

blood  should  he  injected  into  the  circulation  to  obtain  the 
most  accurate  and  rapid  results. 

Prognosis.— In  the  acute  form,  the  prognosis  is  very  unfavor- 
able, the  animals  grow  weak  rapidly,  and  die  from  exhaustion 
in  from  three  to  six  days.  In  the  chronic  form  recovery  often 
takes  place  after  several  weeks. 

Treatment.— In  the  acute  form,  treatment  has  but  little 
effect  on  the  course  of  the  disease.  Symptomatic  treatment 
must  be  used.  When  there  is  extreme  weakness  and  sub- 
normal temperature  stimulants,  such  as  strychnin  sulphate 
(0.001  subcutaneously) ,  or  diffusible  stimulants  should  be 
given  as  often  as  necessary  to  keep  up  the  circulation  and 
general  condition  of  the  animal.  Quinin  (0.3-1.0)  two  or 
three  times  daily  has  been  highly  recommended. 

The  treatment  in  the  chronic  form  is  very  similar.  Plenty 
of  good  nutritious  food  should  be  given  to  conserve  the 
strength  of  the  patient. 


EQUIVALENT  OF  METRIC  WEIGHTS 


637 


EQUIVALENTS  OF  APOTHECARIES  IN  METRIC  MEASURES. 


Cubic 

Cubic 

Minims. 

Centimeters.     Fluidrams. 

Centimeters. 

1      

0.061          1      .      . 

.      .      .      .            3.7 

2      

0.123         2      .      . 

.      .      .      .            7.39 

3      

0.185         3      .      . 

.      .      .      .          11.09 

4      

0.246         4      .      . 

.      .      .      .          15.00 

5     

0.308         5      .      . 

.      .      .      .          18.50 

6      

0.370         6      .      . 

.      .      .      .          22.50 

7      

0.431         7      .      . 

.      .      .      .          26.00 

8      

0.493 

9      

0.554 

Cubic 

10     

0.616     Fluidounces 

Centimeters. 

11      

0.678         1      .      . 

.      .      .      .          29.57 

12     

0.739         2      .      . 

.      .      .      .          59.14 

13      

0.801         3      .      . 

.      .      .      .          89.00 

14      

0.863         4      .      . 

.      .      .      .        118.29 

15      

0.924         5      .      . 

.      .      .      .        148.00 

16      

1.00           6      .      . 

.      .      .      .        177.42 

17     

1.06           7      .      . 

.      .      ."     .        207.00 

18     ...... 

1.12           8      .      . 

.      .      .      .        236.59 

20     

1.23           9      .      . 

.      .      .      .        266.16 

30      

1.84         10      .. 

.      .      .      .        295.73 

40      

2.46         12      .      . 

.      .      .      .        355.00 

50      

3.08         16     .      . 

.      .      .      .        473.17 

20     .      . 

.      .      .      .        591.50 

24      .      . 

.      .      .      .        710.00 

32      .      . 

.      .      .      .        946.35 

128     .      . 

.      .      .      .      3785.43 

EQUIVALENTS 

OF  APOTHECARIES  IN 

METRIC  WEIGHTS. 

Grain. 

Grams.           Grain. 

Grams. 

1-1000      .      .      . 

.000065        1-2 

0324 

1-500        .      .      . 

.000129        1      .      . 

.      .      .      .            .0648 

1-250        .      .      . 

.000258       2      .      . 

1296 

1-200        .      .      . 

.000324       3      .      . 

1944 

1-150        .      .      . 

.00043         4      .      . 

2592 

1-120        .      . 

.00054          5      .      . 

3240 

1-100        .      . 

.00064          6      .      . 

3888 

1-75    .      . 

.00086          7      .      . 

.      .      .      .             .4536 

1-60    .      . 

.00108         8      .      . 

.      .      .      .             .5184 

1-50   .      .      . 

.00129         9      .      . 

5832 

1-40    .... 

.00162       10      .      . 

6480 

1-30    .      .      . 

.00216       11      .      . 

7128 

1-25    .      .      . 

.00259       12      .      . 

7776 

1-20    .      .      . 

.00324       13      .      . 

8424 

1-12    .      . 

.00540        14      .      . 

9072 

1-10    .... 

.00649        15      .      . 

.      .      .      .            .9720 

1-8      .      . 

.0081          20      .      . 

.      .      .      .          1.2960 

1-6      ... 

.0108          25      .      . 

.      .      .      .          1.6200 

1-5      ... 

.0129         30      .      . 

.      .      .      .          1.9440 

1-4      .      . 

.0162         35      .      . 

.      .      .      .          2.2680 

1-3     .      . 

.0216         40     .      . 

.      .      .      .          2.2920 

638 


EQUIVALENTS  OF  METRIC   WEIGHTS 


Grain. 

Grams. 

Ounces. 

Grams. 

45    .      .      .      . 

2.9160 

3      .      .      .      . 

.      .         93.310 

50    .      .      .      . 

3.2400 

4      ... 

.      .         124.414 

55    .... 

3.5640 

5      .      .      .      . 

.      .        155.517 

59    .... 

.      .          3.8232 

6      .      .      .      . 

.      .        186.631 

7      .      .      .      . 

.      .        217.724 

Drams. 

Grams. 

8      .      .      .      . 
9      .      .      .      . 

.      .        248.828 
.      .        279.930 

1    .... 

2    .... 

.      .          3  .  88 
7.776 

10      .      .      .      . 

.      .        311.035 

3    .... 
4    .... 
5    .... 
6    . 

7    .... 

11.664 
.      .        15.552 
.      .        19.440 
.      .        23.328 
.      .        27.216 

11      .      . 
12      .       .       .       . 
14      .      .      .      . 
16      .      .      .      . 
20     .      .      .      . 
24      .       .       .      . 

342.138 
.      .        373.242 
.      .        435.449 
.      .        497.656 
.      .        622.070 
.      .        746.484 

32      .       .       .       . 

.      .        995.312 

Ounces. 

Grams. 

48      .       .       .       . 

.      .      1492.968 

1    . 

.      .        31.103 

64      .      .       .       . 

.      .      1990.624 

2    . 

62.207 

100      .      . 

.      .      3110.350 

INDEX. 


A 

ABSCESS  of  cornea,  534 
of  kidney,  396 
of  liver,  236 
renal,  397 
Acne,  468 
definition,  468 
etiology,  468,  469 
pathology,  469 
prognosis,  469 
symptoms,  469 
treatment,  469 
Actinomyces  canis,  623 
Adhesions  of  eyelids,  504,  505 
ankyloblepharon,  505 

treatment,  505 
symblepharon,  505 

treatment,  505,  506 
Alopecia,  465 
definition,  465 
diagnosis,  466 

differential,  466 
etiology,  465 
pathology,  465 
prognosis,  466 
symptoms,  465,  466 
treatment,  466 
Alveolar  periostitis,  108 
Amaurosis,  547 
Amblyppia,  547 
Amyloid  kidney,  407 
liver,  242 

definition,  242 
etiology,  242 
pathology,  242,  243 
symptoms,  243 
Anal  glands,  suppuration  of, 

224 

Anemia,  319 
of  brain,  437 


223 , 


Anemia  of  brain,  definition,  437 
etiology,  437 
pathology,  438 
prognosis,  438 
symptoms,  438 
treatment,  438 
cerebral,  437 
course,  321 
definition,  319 
diagnosis,  321 
etiology,  319,  320 
occurrence,  319 
pathology,  320 
prognosis,  321 
symptoms,  320,  321 
treatment,  321,  322 
Animal  parasites  in  blood,  330 
in  kidney,  407 
in  trachea  and  bronchial  tubes, 

42 

Ankyloblepharon,  505 
Ankylostoma  canina,  207 
Ankylostomum  stenocephalum,  207 

trigonacephalum,  207 
Anthrax,  599 
Aphtha,  100 
Aphthae  epizooticse,  600 
Apoplexia  hepatis,  246 
Apoplexy,  440 
definition,  440 
diagnosis,  441 
etiology,  440 
pathology,  440 
prognosis,  441 
symptoms,  440,  441 
treatment,  441 
Arthritis,  383 

urica,  354 

Articular  rheumatism,  363 
Articulations,  dislocation  of,  378 
caudal  vertebra,  383 


040 


INDEX 


Articulations,  dislocations  of,  cau- 
dal coxofemoral,  381 
etiology,  381 
prognosis,  381 
symptoms,  381 
treatment,  382 
humero-radio-ulnar,  379,  380 
etiology,  380 
prognosis,  380 
symptoms,  380 
treatment,  380 
patellar,  382 
etiology,  382 
prognosis,  382 
symptoms,  382 
treatment,  382,  383 
phalangeal,  381 
radio-ulnar-carpal,  380 
diagnosis,  380 
symptoms,  380 
treatment,  380,  381 
scapulohumeral,  379 
etiology,  379 
prognosis,  379 
symptoms,  379 
treatment,  379 
temporomaxillary,  378 
etiology,  378 
prognosis,  378 
symptoms,  378 
treatment,  378 
tibiotarsal,  383 
vertebral,  379 
inflammation  of,  383 
sprains  and  injuries  to,  377 
course,  377 
prognosis,  377 
symptoms,  377 
treatment,  377 
wounds  of,  376 
diagnosis,  376 
etiology,  376 
prognosis,  376 
symptoms,  376 
treatment,  376,  377 
Ascaridir,  201 
Ascites,  257  . 
definition,  257 
diagnosis,  259,  260 
etiology,  257,  258 
pathology,  258 
prognosis,  260 
symptoms,  258,  259 


Ascites,  treatment,  260,  261 
Aspergillosis,  40 

Asthenia,  infectious,  of  birds,  191 
definition,  191 
diagnosis,  191,  192 
etiology,  191 
pathology,  191 
prevention,  192 
prognosis,  192 
symptoms,  191 
.    treatment,  192 
Atrophy  of  liver,  240 
definition,  240 
diagnosis,  241 
etiology,  240,  241 
pathology,  241 
prognosis,  241 
symptoms,  241 
treatment,  241 
of  optic  nerve,  547 
definition,  547 
prognosis,  547 

Auditory  nerve,  paralysis  of,  453 
Avian  tuberculosis,  616 


B 


BALANITIS,  265 
Basedow's  disease,  343 
Belascaris  marginata,  202 

myxtax,  202 

Benign  neoplasms  of  mouth,  102 
tumors  of  mammary  glands,  317 
fibromata,  317,  318 
lipoma,  318 
Biliary  fever,  633 
Black  tongue,  579 
Blackhead,  627 
Bladder,  calculi  in,  420 
catarrh  of,  416 
diseases  of,  410 

examination,  410,  411,  412 
by  laparotomy,  411 
by  palpation,  410,  411 
of  urine,  411,  412 
incontinence  of  urine  in,  416     , 
parasites  in,  423,  424 
retention  of  urine  in,  414 
rupture  of,  412 
torsion  of,  420 
tumors  in,  423 


INDEX 


041 


Bladder,  wounds  of,  412 
Blennorrhea,  512 
Blepharitis,  498 
definition,  498 
etiology,  498 
prognosis,  498 
symptoms,  498 
treatment,  498,  499 
Blepharoptosis,  501 
Blepharospasm,  503 
Bothriocephalus  felis,  197 
Brachial  plexus,  paralysis  of,  455 
Brain,  anemia  of,  437 
congestion  of,  435 
diseases  of,  431 

examination,  432,  433,  434,435 
psychic  disturbances,  433 
sensibility,  433,  434,  435 
general  considerations,  431,432 
cerebellum,  432 
cortex,  431,  432 
midbrain,  432 
hyperemia  of,  435 
tumors  of,  441,  442 
Bi  ittleness  of  bones,  362 
Bronchial  catarrh  of  birds,  38 
tubes  and  trachea,  animal  para- 
sites in,  42 
Bronchitis,  38 
and  tracheitis,  34 
acute,  34 
chronic,  44 
Bronchocele,  336 
Bronchopneumonia,  53 
definition,  53 
diagnosis,  56 
etiology,  53,  54 
pathology,  54,  55 
prognosis,  56 
symptoms,  55,  56 
treatment,  56 
Bulbar  paralysis,  infectious,  611 


CALCULI  in  bladder,  420 
etiology,  420,  421 
forms  and  varieties,  421 
acid  urine  calculi,  421 
alkaline  urine  calculi,  421 
prognosis,  422 
symptoms,  421,  422 
41 


Calculi  in  bladder,  treatment,  422, 

423 
in  kidney,  402 

definition,  402 

diagnosis,  403 

etiology,  402 

pathology,  402 

prognosis,  403 

symptoms,  402,  403 

treatment,  403,  404 
in  urethra,  427 

prognosis,  428 

symptoms,  427,  428 

treatment,  428,  429 
Canine  typhus,  579 
Canker,  593 

of  mouth,  97 

Caponizing,  276,  277,  278 
Carcinomata  of  bladder,  423 
of  eyelids,  509 
of  mammary  glands,  318 
of  penis  and  prepuce,  269 
of  scrotum  and  testes,  273 
Caries  of  teeth,  109 

definition,  109 

etiology,  109 

pathology,  109,  110 

symptoms,  110 

treatment,  110 
Castration,  273 

of  birds,  276,  277,  278 
of  cat,  275,  276 
of  dog,  274,  275 

cryptorchid,  275 

monorchid,  275 
Catalepsy,  460 
course,  460 
definition,  46Q 
diagnosis,  460 
etiology,  460 
pathology,  460 
prognosis,  460 
symptoms,  460 
treatment,  460 
Cataract,  542 
course,  543 
definition,  542 
forms,  542 

congenital,  543 

diabetic,  543 

senile,  542 

symptomatic,  542 

traumatic,  542 


642 


INDEX 


Cataract,  prognosis,  543 
symptoms,  543 
treatment,  543,  544 
discission,  543,  544 
extraction,  544 
Catarrh  of  bladder,  416 
definition,  416 
diagnosis,  419 
etiology,  416,  417 
pathology,  417,  418 
prognosis,  419 
symptoms,  418,  419 
treatment,  419,  420 
bronchial,  of  birds,  38 
definition,  38 
diagnosis,  39 
etiology,  39 
prognosis,  39 
symptoms,  39 
treatment,  39,  40 
chronic,  of  stomach,  146 
of  crop  in  birds,  137 
definition,  137 
diagnosis,  138 
etiology,  137,  138 
prognosis,  138 
symptoms,  138 
treatment,  138,  139 
nasal,  acute,  19 
definition,  19 
diagnosis,  19 
etiology,  19 
prognosis,  19 
symptoms,  19 
treatment,  19,  20 
chronic,  23. 
definition,  23 
diagnosis,  24 
etiology,  23 
pathology,  23 
prognosis,  24 
symptoms,  23,  24 
treatment,  24 
of  rabbits,  20 
infectious,  20 
definition,  20 
diagnosis,  21 
etiology,  20,  21 
necropsy,  21 
prognosis,  21 
prophylaxis,  22 
symptoms,  21 
treatment,  21 


Catarrh,  nasal,   of  rabbits,  para- 
sitic, 22 
definition,  22 
diagnosis,  23 
etiology,  22 
prevention.  23 
prognosis,  23 
symptoms,  22 
treatment,  23 
preputial,  265 
definition,  265 
etiology,  265,  266 
prognosis,  266 
symptoms,  266 
treatment,  266 
simple,  of  stomach,  142 
Catarrhal  conjunctivitis,  511 
pneumonia,  53 
stomatitis,  94 

Caudal  vertebrae,  dislocation  of,383 
Cerebral  anemia,  437 

hemorrhage,  440 
Cestoda,  193,  194,  195 
species,  195 
tseniae,  195 

in  intestine  of  birds,  198 
of  cats,  197 
of  dogs,  195,  196,  197 
of  rabbits,  197,  198 
Chalazion  of  eyelids,  507 
Chicken-pox,  593 

Choanptsnia  infundibuliformis,198 
Cholelithiasis,  245 
symptoms,  245 
treatment,  245 
Cholera,  fowl,  584 
gallinarum,  584 
Chorea,  461 
definition,  461 
diagnosis,  461 
etiology,  461 
pathology,  461 
prognosis,  461 
symptoms,  461 
treatment,  461 

Chronic  catarrh  of  stomach,  146 
coryza,  23 

dilatation  of  stomach,  154 
dyspepsia,  146 
enteritis,  173 
gastritis,  146 
interstitial  hepatitis,  243 
pneumonia,  57 


INDEX 


643 


Chronic  inetritis,  29G 
nasal  catarrh,  23 
peritonitis,  255 
pharyngitis,  125 
rhinitis,  23 

tracheitis  and  bronchitis,  44 
Cirrhosis  of  liver,  243 
definition,  243 
diagnosis,  244 
etiology,  243 
pathology,  243 
prognosis,  244 
symptoms,  243,  244 
treatment,  244 
of  lungs,  57 
definition,  57 
diagnosis,  58 
etiology,  57,  58 
pathology,  58 
prognosis,  58 
symptoms,  58 
treatment,  58 

Cittotsenia  denticulata,  197 
Coccidia  in  kidney,  409 
Coccidium  tenellum  in  kidney,  409 
Comb  disease,  484 

white,  484 
Compression  of  peripheral  nerves, 

450 

of  spinal  cord,  448 
definition,  448 
diagnosis,  449 
etiology,  448,  449 
pathogenesis,  449 
prognosis,  449 
symptoms,  449 
treatment,  449 
Concha,  ulceration  of,  488 
Concussion  of  spinal  cord,  445 
course,  447 
diagnosis,  447 
etiology,  445 
pathogenesis,  446 
prognosis,  447 
symptoms,  446,  447 
treatment,  448 

Congenital  defects  of  iris,  539 
malformations  of  penis  and  pre- 
puce, 265 
of  urethra,  425 
of  vagina  and  vulva,  309 
Congestion  of  brain,  435 
of  kidney,  387 


Congestion  of  liver,  231 
active,  231 

course,  232 

definition,  231 

diagnosis,  232 

etiology,  231 

pathology,  231 

prognosis,  232 

symptoms,  232 

treatment,  232,  233 
passive,  233 

definition,  233 

diagnosis,  234 

etiology,  233 

pathology,  233,  234 

prognosis;  234 

symptoms,  234 

treatment,  235 
of  lungs,  49 
active,  49 

diagnosis,  50 

etiology,  49 

pathology,  49 

prognosis,  50 

symptoms,  49,  50 

treatment,  50 
passive,  50 

diagnosis,  51 

etiology,  50,  51 

pathology,  51 

prognosis,  51 

symptoms,  51 

treatment,  51,  52 
of  mammary  glands,  316 
of  thyroid  glands,  334,  335 
Conjunctiva,  corrosions  and  burns 

of,  521 
diseases  of,  510 

examination,  510 
foreign  bodies  in,  519,  520 
growths  on,  522 
traumatic  lesions  of,  519 
tumors  on,  522 
ulceration  of,  521 
wounds  on, 520 
Conjunctivitis,  510 
definition,  510 
forms,  510 
catarrhal,  511 

etiology,  511 

prognosis,  511 

symptoms,  511 

treatment,  511,  512 


644 


INDEX 


Conjunctivitis,    forms,     crotipous, 

516 

definition,  516 
etiology,  516 
prognosis,  516 
symptoms,  516 
treatment,  516 
erysij)elatous,  514 
exanthematous,  518 
definition,  518 
treatment,  519 
follicular,  517 
definition,  517 
etiology,  517 
prognosis,  517 
symptoms,  517 
treatment,  517,  518 
parenrhymatous,  514 
definition,  514,  515 
etiology,  515 
prognosis,  515 
symptoms,  515 
treatment,  515,  516 
purulent,  512 
acute,  512 
definition,  512 
etiology,  512 
prognosis,  513 
symptoms,  512,  513 
treatment,  513,  514 
chronic,  514 
prognosis,  514 
symptoms,  514 
treatment,  514 
Constipation,  182 
definition,  182 
diagnosis,  183 
etiology,  182 
pathology,  182 
prognosis,  183 
symptoms,  182,  183 
treatment,  183,  184,  185 
Contagious  epithelioma,  593 
Cornea,  abscess  of,  534 
diseases  of,  526 

examination,  526 
ectasia  of,  537 
foreign  bodies  of-,  535 
opacities  of,  536 
tumors  of,  538 
ulceration  of,  532 
wounds  of,  535 
Cornua  uteri,  torsion  of,  302 


Corrosions  and  burns  of  conjunc- 
tiva, 521 
treatment,  521 
Coryza,  19 

chronic,  19 

Coxofemoral  dislocation,  381 
Cranial  bones,  fracture  of,  368 
Crop,  catarrh  of,  in  birds,  137 

hard,  139 

obstruction  of,  in  birds,  139 

soft,  137 
Croupous  conjunctivitis,  516 

enteritis  of  cats,  190 

pharyngitis  of  birds,  127 
Ctenocephalus  canis  of  dog,  472, 
633 

felis  of  cat,  472 
Cuterebra  emasculator,  273 
Cyclitis,  540 
Cystic  goiter,  339 

kidney,  405 

Cysticercus  cellulosa;  in  kidney,  409 
Cystitis,  416 
Cysts  of  ear,  494 

of  eyelids,  507 
Meibomian,  507 
pilosebaceous,  507 

of  iris,  541 

of  ovaries,  284 

retention,  in  mouth,  103 

of  uterine  tubes,  291 


DACRYOCYSTITIS,  525 

definition,  525 

prognosis,  525 

symptoms,  525 

treatment,  525 
Dandruff,  464 

definition,  464 

diagnosis,  464 

etiology,  464 

prognosis,  464 

symptoms,  464 

treatment,  464,  465 
Davainea  cesticillus,  198 

crassula,  198 

echinobothrida,  198 

proglottina,  198 

tetragona,  198 
u  Deafness,  495 


INDEX 


645 


Deafness,  etiology,  495 
prognosis,  495 
symptoms,  495 
treatment,  495 

Defects,  congenital,  of  iris,  539 
aniridia,  539 
coloboma,  539 
ectopic  pupillie,  539 
occlusion  of  pupil,  539 
Demodex  folliculorum,  480 

mite,  480  . 

Dermacentor  variabilis,  633 
Dermatitis,  466 
definition,  466 
diagnosis,  468 
etiology,  466,  467 
pathology,  467 
prognosis,  468 
symptoms,  467,  468 
treatment,  468 
Dermatomycosis,  482 
definition,  482 
examination,  482 
Diabetes,  347 
definition,  347 
insipidus,  347 
course,  349 
definition,  347 
diagnosis,  349 
etiology,  347,  348 
occurrence,  347 
pathology,  348 
prognosis,  349 
symptoms,  348,  349 
treatment,  349,  350 
mellitus,  350 
course,  351 
definition,  350 
diagnosis,  351 
etiology,  350 
occurrence,  350 
pathology,  350 
prognosis,  351 
symptoms,  350,  351 
treatment,  351,  352 
Diaphragmatic  hernia,  563 
Diarrhea,  178 
definition,  178 
diagnosis,  181 
etiology,  178,  179,  180 
infectious,  of  chicks,  629 
definition,  629 
diagnosis,  631 


Diarrhea,     infectious,    of     chicks, 

etiology,  629,  630 
necropsy,  630 
pathogenesis,  630,  631 
prevention,  632,  633 
prognosis,  632 
symptoms,  631 
treatment,  632 
prognosis,  181 

symptoms,  180  . 

treatment,  181 
white,  629 

Dicranotaenia  sphenoides,  198 
Dilatation  and  diverticula  of  esoph- 
agus, 136 
definition,  136 
diagnosis,  137 
etiology,  136,  137 
prognosis,  137 
symptoms,  137 
treatment,  137 
of  stomach,  152 
acute,  152 
diagnosis,  154 
etiology,  152,  153 
pathology,  153 
prognosis,  154 
symptoms,  153,  154 
treatment,  154 
chronic,  154 
diagnosis,  157 
etiology,  154,  155 
pathology,  155,  156 
prognosis,  157 
symptoms,  156 
treatment,  157 
Dioctophyme  renale,  in  bladder,423 

in  kidney,  407 
Diphtheria,  593 
Dipylidium  caninum,  195 
Dirofilaria  immitis  in  blood,  330 
Dislocation  of  articulations,  378 
Dispharagus  nosutus  in  stomach  of 

birds,  163 

spiralis  in  stomach  of  birds,  163 
Distemper  of  cats,  577 
definition,  577 
diagnosis,  578 
etiology,  577 
pathology,  577 
prognosis,  578 
symptoms,  577,  578 
treatment,  578,  579 


646 


INDEX 


Distemper  of  dogs,  565 
definition,  565 
diagnosis,  572,  573 
etiology,  565,  566 
natural  infection,  566 
necropsy,  566,  567 
occurrence,  565 
prevention,  577 
prognosis.  573 
symptoms,  567,  568,  569,  570, 

571,  572 

treatment,  573,  574,  575,  576 
rabbit,  20 
Districhiasis,  504 
Diverticula  of  esophagus,  136 
Dochmius  trigonacephulus,  207 
Dog  plague,  579 
Dropsy  of  kidney,  405 
definition,  405 
diagnosis,  406 
etiology,  405,  406 
pathology,  406 
prognosis,  406 
symptoms,  406 
treatment,  406 
of  pericardium,  76 
Dyspepsia,  acute,  142 

chronic,  146 
Dystocia,  305 
definition,  305 
diagnosis,  307 
etiology,  305,  306 
prognosis,  307 
symptoms,  306,  307 
treatment,  307,  308 


EAR,  diseases  of,  487 
examination,  487 
fistula,  495 
etiology,  495 
prognosis,  496 
symptoms,  4% 
treatment,  496 
neoplasms  of,  493 
parasites  in,  494 
wounds  of,  487,  488 
Echinococcus  granulosus,  197 
Kchinorhynchus  canis,  202 
Eclampsia,  461 
definition,  461 


Eclampsia,  diagnosis,  462 
etiology,  462 
prognosis,  462 
symptoms,  462 
treatment,  462 
Ectasia  of  cornea,  537 
inflammatory,  537 
forms,  537 

keratectasia,  537 
definition,  537,  538 
treatment,  538 
staphyloma,  537 
definition,  537 
treatment,  537 
non-inflammatory,  538 
forms,  538 

keratoconus,  538 
keratoglobus,  538 
treatment,  538 
Ectropion,  500 
Eczema,  469 
definition,  469 
diagnosis,  471 
etiology,  470 
pathology,  470 
prognosis,  471 
symptoms,  470 
treatment,  471 
Edema  of  lungs,  52 

pulmonary,  52 

Eimeria  avium  in  kidney,  409 
Empyema  of  infraorbital  fossae  of 

birds,  20 
definition,  20 
etiology,  20 
prognosis,  20 
symptoms,  20 
treatment,  20 
Endocarditis,  acute,  85 
definition,  85 
diagnosis,  88 
etiology,  85,  86 
necropsy,  86,  87 
prognosis,  88 
symptoms,  87,  88 
treatment,  88,  89 
Enophthalmus,  551 
definition,  551 
etiology,  551 
prognosis,  552 
symptoms,  551 
treatment,  552 
Enteritis,  167 


INDEX 


647 


Enteritis,  acute,  167 
definition,  1G7,  168 
diagnosis,  171 
etiology,  168,  169 
pathology,  169 
prognosis,  171 
symptoms,  169,  170,  171 
treatment,  171,  172,  173 
chronic,  173 
definition,  173 
diagnosis,  174,  175 
etiology,  173 
pathology,  173,  174 
prognosis,  175 
symptoms,  174 
treatment,  175 
croupous,  of  cats,  190 
definition,  190 
diagnosis,  190 
etiology,  190 
pathology,  190 
prognosis,  190 
symptoms,  190 
treatment,  191 
membranous,  190 
Enterohepatitis,  627 
definition,  627 
diagnosis,  628 
etiology,  627 
necropsy.  627,  628 
occurrence,  627 
pathogenesis,  627 
prognosis,  629 
symptoms,  628 
treatment,  629 
Enterorrhagia,  175 
Entropion,  499 
Epilepsy,  458 
definition,  458 
diagnosis,  459 
etiology,  458 
pathology,  458 
prognosis,  459 
reflex,  459,  460 

treatment,  460 
secondary,  459,  460 
symptoms,  459 
treatment,  459 
Epiphora,  524 
Epistaxis,  24 
definition,  24 
etiology,  24,  25 
prognosis,  25 


Epistaxis,  symptoms,  25 

treatment,  25 

|  Epithelioma,  contagious,  593 
Epitheliomata  of  eyelids,  509 
of  mouth,  104 
of  penis  and  prepuce,  269 
of  pharynx,  129 

Epitheliosis  infectiosa  avium,  593 
diagnosis,  598 
etiology,  593 

natural  infection,  594,  595 
pathogenesis,  593,  594 
pathology,  595,  598 
pre valency  and  distribution, 

593 

prevention,  599 
prognosis,  599 
symptoms,  593,  597,  598 
treatment,  599 
Esophagismus,  135 
definition,  135 
etiology,  135 
prognosis,  135 
symptoms,  135 
treatment,  135 
Esophagitis,  130 
course,  131 
definition,  130 
etiology,  130 
pathology,  130,  131 
prognosis,  131 
symptoms,  131 
treatment,  131 

Esophagus,  dilatations  of,  136 
diseases  of,  130 

examination,  130 
diverticula  of,  136 
foreign  bodies  in,  131 
neoplasms  of,  141 
obstruction  in,  131 
stricture  of,  135 
Eustrongylus  gigas,  407 
Eversion  of  uterus,  300 
diagnosis,  301 
prognosis,  301 
symptoms,  301 
treatment,  301,  302 
Exanthematpus  conjunctivitis,  518 
Exophthalmic  goiter,  343 
Exophthalmus,  550 
definition,  550 
etiology,  550 
prognosis,  550 


048 


INDEX 


Exophthahnus,  symptoms,  550 

treat  men  I,  550 
Eye,  parasites  of,  553 
Eyeball,  luxation  of,  550 
Eyelidd,  adhesions  of,  504,  50(5 

diseases  of,  497 
examination,  497 

inflammation  of,  498 

malposition  of,  499 

tumors  of,  506 

wounds  of,  497,  498 


F 


FACETTED  keratitis,  529 
Facial  nerve,  paralysis  of,  450 
Fatty  liver,  241 
definition,  241 
etiology,  241,  242 
pathology,  242 
symptoms,  242 
Favus,  484 
diagnosis,  485 
etiology,  484 
pathology,  484 
prognosis,  485 
symptoms,  484,  485 
treatment,  485 
Feather  eating  in  birds,  357 
etiology,  357 
symptoms,  357 
treatment,  357,  358 
pulling  in  birds,  357 
Femoral  hernia,  562 
Femur,  fracture  of,  374 
Fetid  stomatitis,  96 
Fibromata  of  bladder,  423 
of  mammary  glands,  317,  318 
of  mouth,  102 

of  scrotum  and  testes,  272,  273 
of  "uterus,  303,  304 
of  vulva  and  vagina,  313 
Fibrous  goiter,  340 
Filaria  immitis  in  blood,  330 
Filarida-,  330 
Fistula,  ear,  495 
salivary,  118 
definition,  1 18 
diagnosis,  119 
etiology,  118 
pathology,  118 
prognosis,  119 


Fistula,  salivary,  symptoms,    118, 

119 

treatment,  119 
Fleas,  472 
description,  472 
diagnosis,  473 
occurrence,  472 

Ctenocephalus   canis   of  dog, 

472 

felis  of  cat,  472 
Pulex  avium  of  bird,  472 

gonivcephalus  of  rab- 
bit, 472 

irritans  of  man,  472 
symptoms,  472,  473 
treatment,  473 
Follicular  conjunctivitis,  517 
Foot-and-mouth  disease, -600 
Foreign-body  pneumonia,.  58 
Foreign    bodies    and    wounds    of 

cornea,  535 
prognosis,  536 
symptoms,  535 
treatment,  536 
in  conjunctiva,  519,  520 
in  esophagus,  131 
diagnosis,  133 
etiology,  131,  132 
prognosis,  133 
symptoms,  132,  133 
treatment,  133,  134,  135 
in  mouth,  106 
symptoms,  106 
treatment,  106 
in  pharynx,  126 
diagnosis,  126 
prognosis,  126 
symptoms,  126 
treatment,  126,  127 
in  stomach,  148 
diagnosis,  149,  150 
etiology,  148,  149 
prognosis,  150 
symptoms,  149 
treatment,  150,  151,  152 
Fowl  cholera;  584 
definition,  584 
diagnosis,  587,  588 
etiology,  584 
natural  infection,  585 
occurrence,  584 
pathogenesis,  584,  585 
pathology,  586 


INDEX 


649 


Fowl  cholera,  prevention,  589 
prognosis,  588 
symptoms,  587 
treatment,  588,  589 
pest,  589 

definition,  589 
diagnosis,  591 
etiology,  590 
natural  infection,  590 
occurrence,  589,  590 
pathogenicity,  590 
pathology,  590,  591 
prognosis,  592 
symptoms,  591 
treatment,  592 
plague,  589 
typhoid,  584 
Fracture  of  bones,  368 
cranial,  368 
etiology,  368 
prognosis,  369 
symptoms,  368,  369 
treatment,  369 
femur,  374 
diagnosis,  375 
etiology,  374 
prognosis,  375 
symptoms,  375 
treatment,  375 
humerus,  372 
diagnosis,  372 
etiology,  372 
prognosis,  372 
symptoms,  372 
treatment,  372 
inferior  maxilla,  369 
etiology,  370 
prognosis,  370 
symptoms,  370 
treatment,  370 
metacarpal  and    phalangoal, 

373 

diagnosis,  373 
treatment,  373 
patella,  375 
I>elvis,  373,  374 
etiology,  374 
prognosis,  374 
symptoms,  374 
treatment,  374 
radius  and  ulna,  372,  373 
etiology,  373 
symptoms,  373 


Fracture  of  bones,  radius  and  ulna, 

treatment,  373 
ribs,  371 

etiology,  371 

prognosis,  371 

symptoms,  371 

treatment,  371 
scapula,  371 

etiology,  372 

symptoms,  372 

treatment,  372 
tibia  and  fibula,  375 
vertebra?,  370 

etiology,  370 

prognosis,  371 

symptoms,  370,  371 

treatment,  371 
of  orbit,  553 

treatment,  553 
of  teeth,  108 
treatment,  108 


G 

GALL-STONES,  245 
Gangrene  of  lungs,  58 
of  tongue,  112 

definition,  112 

diagnosis,  113 

etiology,  113 

pathology,  113 

prognosis,  113 

symptoms,  113 

treatment,  113,  114 
Gangrenous  glossitis,  112 

stomatitis,  97 
Gapes  in  chickens,  42 
Gastritis,  142 
acute,  142 

definition.  142 

diagnosis,  144 

etiology,  142,  143 

pathology;  143 

prognosis,  144 

symptoms,  143 

treatment,  144,  145,  146 
chronic,  146 

definition,  146 

diagnosis,  147 

etiology,  146 

pathology,  146 

prognosis,  147 


INDEX 


Gastritis,  chronic,  symptoms,  146 

treatment,  147,  148 
Gastro-enteritis,  hemorrhagic,  579 

infectious,  000 

Gastrophilus  intestinalis  in  stom- 
ach of  dog,  163 
Glanders,  622 

Glands  of  Moll,  enlargement  of,  508 
submaxillary  and  sublingual,  dis- 
eases of,  118 
symptoms,  118 
treatment,  118 
Glaucoma,  549 
definition,  549 
prognosis,  549 
symptoms,  549 
treatment,  549 

Globe  and  orbit,  diseases  of,  548 
Glossitis,  111 
definition,  111 
etiology,  111,  112 
gangrenous,  112 
pathology,  112 
prognosis,  112 
symptoms,  112 
treatment,  112 
Goiter,  336 
cystic,  339 
definition,  339 
diagnosis,  339 
prognosis,  339 
symptoms,  339 
treatment,  339,  340 
definition,  336 
exophthalmic,  343 
definition,  343 
diagnosis,  345 
etiology,  343 
pathogenesis,  343 
pathology,  343 
prognosis,  345 
symptoms,  344 
treatment,  345 
fibrous,  340 
definition,  340 
diagnosis,  340 
prognosis,  340,  341 
symptoms,  340 
treatment,  341 
malignant,  342 
definition,  342 
diagnosis,  342,  343 
prognosis,  343 


Goiter,  malignant,  symptoms,  342 

treatment,  343 
occurrence,  336 
parenchymatous,  336 

definition,  336 

diagnosis,  337,  338 

occurrence,  336 

prognosis,  338 

symptoms,  336,  337 

treatment,  338 
vascular,  341 

definition,  341 

diagnosis,  341,  342 

prognosis,  342 

symptoms,  341 

treatment,  342 
Gout,  354 
course,  356 
definition,  354 
diagnosis,  356 
etiology,  354,  355 
occurrence,  354 
pathogenesis,  355 
pathology,  355 
symptoms,  355,  356 
treatment,  356,  357 
Granulomas  of  eyelids,  510 
Graves's  disease,  343 


H^EMAPHYSALIS  L.EACHI,  633 

Hsemostrongylus  vasorum  in  blood, 

332 

Hard  crop,  139 
Heart,  diseases  of,  78 

hypertrophy  and  dilatation  of,  89 

rupture  of,  92 
Helminthiasis,  193 
Hematemesis,  160 

definition,  160 

diagnosis,  161,  162 

etiology,  160 

pathology,  160,  161 

prognosis,  162 

symptoms,  161 

treatment,  162 
Hematoma,  489 

diagnosis,  490 

etiology,  489 

prognosis,  490 

symptoms,  489,  490 


INDEX 


651 


Hematoma,  treatment,  490 
Hematozoon  Lewis!  in  blood,  332 
Hemopericardium,  77 
definition,  77 
etiology,  77 
symptoms,  77 
treatment,  77 
Hemophilia,  328 
Hemorrhage,  cerebral,  440 
intestinal,  175 

definition,  175,  176 
diagnosis,  177 
etiology,  176 
prognosis,  177 
symptoms,  176,  177 
treatment,  177 

Hemorrhagic  gastro-enteritis,  579 
septicemia  of  cats,  600 
diagnosis,  602 
etiology,  600 
occurrence,  600 
pathogenesis,  601 
pathogenicity,  600 
pathology,  601 
prognosis,  602 
symptoms,  601 
treatment,  602 
Hemorrhoids,  216 
definition,  216 
diagnosis,  217 
etiology,  216 
pathology,  216 
prognosis,  217 
symptoms,  216 
treatment,  217 
Hemothorax,  67 
definition,  67 
diagnosis,  68 
etiology,  67 
pathology,  67 
prognosis,  68 
symptoms,  67 
treatment,  68 
Hepatitis,  235 

chronic  interstitial,  243 
definition,  235 
diagnosis,  236 
etiology,  235 
pathology,  235 
prognosis,  236 
suppurative,  236 
definition,  236,  237 
diagnosis,  239 


Hepatitis,    suppurative,    etiology, 

237 

pathology,  237,  238 
prognosis,  239 
symptoms,  238,  239 
treatment,  239,  240 
symptoms,  235,  236 
treatment,  236 
Hernia,  555 
definition,  555 
diaphragmatic,  563 
definition,  563 
etiology,  563 
symptoms,  563 
treatment,  563 
femoral,  562 
symptoms,  562 
treatment,  563 

general  remarks,  555,  556,  557 
hernial  contents,  556 
ring,  555,  556 
sac,  555 

irreducible  hernias,  556,  557 
reducible  hernias,  556 
inguinal,  560 
in  female,  560 
etiology,  560 
symptoms,  560 
treatment,  561 
in  male,  561 
etiology,  561 
symptoms,  561,  562 
treatment,  562 
occurrence,  555 
perinea!,  563 
definition,  563 
etiology,  563 
symptoms,  563,  564 
treatment,  564 
scrotal,  561 

treatment,  562 
umbilical,  557 
etiology,  557 
symptoms,  557 
treatment,  557,  558 
ventral,  558 
definition,  558 
etiology,  558 
symptoms,  558 
treatment,  559,  560 
Herpes  tonsurans,  482 
diagnosis,  483 
etiology,  482 


652 


INDEX 


Herpes  tonsurans,  pathology,  482 
prognosis,  483 
symptoms,  483 
treatment,  483,  484 
Heterakidir,  202 
Heterakis  compressa,  203 

crassa,  203 
*  differens,  203 
.  .  dispar,  203 

inflexa,  203 

lineata,  203 

muculosa,  203 

papillosa,  202.  203 

jxjrspicillum,  203 

vesicularis,  202,  203 
Hodgkin's  disease,  327 
Honeycomb  ringworm,  484 
Hookworm,  206 
Humero-radio-ulnar  dislocation, 

379,  380 

Humerus,  fracture  of,  372 
Hydrometra  of  uterus,  304 
Hydronephrosis,  405 
Hydropericardium,  76 

definition.  76 

etiology,  76 

symptoms,  76 

treatment,  76 
Hydrophobia,  603 
Hydrophthalmus,  550 

definition,  550 

treatment,  550 
Hydrops  abdominis,  257 

ascites,  257 

jxTitonei,  257 
Hydrothorax,  65 

definition,  65 

diagnosis,  66 

etiology,  65 

pathology,  65 

prognosis,  66 

symptoms,  66 

treatment,  66 
Hy|M-remia.  3S7 

acute,  387 
etiology,  387 
pathology,  387.  388 
prognosis,  388 
symptoms,  388 
treatment.  388 

of  brain,  435 
definition,  435 
diagnosis,  436 


Hyperemia  of  brain,  etiology,  435 
pathology,  435.  436 
prognosis,  436 
symptoms,  436 
treatment,  436.  437 
of  lungs,  49 
passive,  388 
etiology,  388 
pathology,  388 
prognosis,  388 
symptoms,  388 
treatment,  388 
Hypertrophy    and    dilatation    of 

heart,  89 
definition,  89 
diagnosis,  91 
etiology,  89,  90 
necropsy,  90 
prognosis,  91 
symptoms,  90,  91 
treatment,  91 
of  prostate  gland,  280 


ICTERUS,  225 
definition,  225 
diagnosis,  229 
etiology,  225,  226 
pathology,  226,  227 
prognosis,  229 
symptoms,  227,  228,  229 
treatment,  229,  230 
Incontinence  of  urine  in  bladder, 

416 

definition,  416 
etiology,  416 
prognosis,  416 
symptoms,  416 
treatment,  416 
Incrustations  of  tartar,  108 
Infectious  asthenia  of  birds,  191 
bulbar  paralysis,  611 
diarrhea  of  chicks,  629 
gastro-enteritis,  600 
jaundice,  633 
leukemia  of  chickens,  325 
nasal  catarrh  of  rabbits,  20 
Inferior  maxilla,  fracture  of,  369 
Inflammation  of  eyelids,  498 
of  kidneys,  388 
of  rnembrana  nictitans,  522 


INDEX 


653 


Inflammation  of  membrana  nicti- 

tans,  examination,  522 
prognosis,  523 
symptoms,  522,  523 
treatment,  523 
of  orbit,  553 
of  ovaries,  283 
definition,  283 
diagnosis,  284 
etiology,  284 
prognosis,  284 
symptoms,  284 
treatment,  284 
of  renal  pelvis,  398 
of  synovial  membrane  and  artic- 
ulations, 383 
definition,  383 
etiology,  383 
prognosis,  383 
symptoms,  383 
treatment,  383,  384 
of  urethra,  429 

Inflammatory  ectasia  of  cornea,  537 
forms,  537 

keratectasia,  537 
staphyloma,  537 
Influenza,  rabbit,  20 
Infraorbital  fossae  of  birds,  empy- 

ema  of, '20 
Inguinal  hernia,  560 
in  female,  560 
in  male,  561 
Injuries  of  peripheral  nerves,  450 

of  spinal  cord,  445 
Insufficiency,  valvular,  78 
Interstitial  hepatitis,  243 

chronic,  243 
pneumonia,  57 

chronic,  57 
Intestinal  hemorrhage,  175 

obstruction,  182 
Intestines,  diseases  of,  167 

examination,  167 
parasites  in,  193 
round  worms  in,  202 
of  birds,  202,  203 
of  cat,  202 
of  dog,  202 
of  rabbit,  202 
strongylidse  in,  207 
of  cat,  207 
of  dog,  207 
of  rabbit,  207 


Intestines,  tacnia  in,  195 
of  birds,  198 
of  cats.,  197 
of  dogs,  195,  196,  197 
of  rabbits,  197,  198 
trichinellidae  in,  209,  210,  211 
of  birds,  210,  211 
of  dog,  210 
of  rabbit,  210 
wounds  of,  188 
Intussusception,  186 
definition,  186 
diagnosis,  187 
etiology,  186 
pathology,  186,  187 
prognosis,  187 
symptoms,  187 
treatment,  187,  188 
Inversion  of  uterus,  300 
Iridocyclitis,  540 
course,  541 
definition,  540 
etiology,  540 
prognosis,  541 
symptoms,  540,  541 
treatment,  541 
Iris  and  ciliary  body,  diseases  of, 

539 

congenital  defects  of,  539 
cysts  of,  541 
tumors  of,  541 
Iritis,  540 
Itch,  475 

red,  482 
Ixodes  ricinus,  633 


JAUNDICE,  225 
infectious,  633 
malignant,  633 


KERATECTASIA,  537 
Keratitis,  526 

definition,  526,  527 
non-suppurative,  527 
keratitis  pigmentosa,  529 
definition,  529 
etiology,  529 


654 


INDEX 


Keratitis,   npn-suppurative,   kera- 
titis pigmentosa,  prog- 
nosis, 529 
symptoms,  529 
treatment,  529 
punctata  profunda,  532 
definition,  532 
etiology,  532 
prognosis,  532 
symptoms,  532 
treatment,  532 
superficialis,  529 
course,  530 
definition,  529,  530 
etiology,  530 
prognosis,  530 
symptoms,  530 
treatment,  530 
parenchymatous,  530 
course,  531 
definition,  530 
etiology,  530,  531 
prognosis,  531 
symptoms,  531 
treatment,  531,  532 
superficial,  527 
course,  527 
definition,  527 
etiology,  527 
prognosis,  527 
symptoms,  527 
treatment,  527,  528 
vascular,  528 
definition,  528 
etiology,  528 
prognosis,  528 
symptoms,  528 
treatment,  528 
suppurative,  527 

abscess  of  cornea,  534 
course,  535 
definition,  534 
etiology,  534 
prognosis,  535 
symptoms,  534,  535 
treatment,  535 
keratitis  from  lagophthalmos, 

535 

definition,  535 
treatment,  535 
neuroparalytica,  535 

definition,  535 
ulceration  of  cornea,  532 


Keratitis,  suppurative,  ulceration 

of  cornea,  course,  533 
definition,  532 
etiology,  532,  533 
prognosis,  533 
symptoms,  533 
treatment,  534 
Keratoconus,  538 
Keratoglobus,  538 
Kidney  abscess,  396 
amyloid,  407 
animal  parasites  in,  407 
coccidia,  409 
Coccidium  tenellum,  409 
Cysticercus  cellulosse,  409 
Dioctophyme  renale,  407 
Eimeria  avium,  409 
Eustrongylus  gigas,  407 
calculi  in,  402 
congestion  of,  387 
cystic,  405 
diseases  of,  385 

examination,  385,  386,  387 
dropsy  of,  405 
inflammation  of,  388 
tumors  in,  407 


LACRIMAL  apparatus,  diseases  of, 

524 

examination,  524 
Lacrimation,  524 
definition,  524 
etiology,  524 
prognosis,  525 
symptoms,  525 
treatment,  525 
Lagophthalmos,  506 
definition,  506 
treatment,  506 
Laryngitis,  30 
acute,  30 
definition,  30 
diagnosis,  31 
etiology,  30 
pathology,  30,  31 
prognosis,  31 
symptoms,  31 
treatment,  31 
chronic,  31 


INDEX 


655 


Laryngitis,  chronic,  definition,  31 
diagnosis,  32 
etiology,  31 
pathology,  32 
prognosis,  32 
symptoms,  32 
treatment,  32,  33 
Larynx,  diseases  of,  30 

examination,  30 
Lens,  diseases  of,  542 
examination,  542 
luxation  of,  544 
Leukemia,  322 
course,  325 
definition,  322,  323 
diagnosis,  325 
etiology,  323 

infectious,  of  chickens,  325 
course,  326 
definition,  325 
diagnosis,  326,  327 
etiology,  325,  326 
occurrence,  325 
pathogenesis,  326 
pathology,  326 
prognosis,  327 
symptoms,  326 
treatment,  327 
lymphatic,  322 
myelogenous,  322 
occurrence,  323 
pathology,  323 
prognosis,  325 
symptoms,  323,  324,  325 
treatment,  325 
Lice,  473 

description,  473,  474 
diagnosis,  475 
kinds,  474 

Linognathus  piliferus,  474 
Menopum  biseriatum,  474 

trigonocephalum,  474 
Trichodectes  latus,  474 

subrostratus,  474 
prognosis,  475 
symptoms,  474,  475 
treatment,  475 
Linognathus  piliferus,  474 
Lipoma  of  eyelids,  in  birds,  508 

of  mammary  glands,  318 
Liver,  abscess  of,  236 
amyloid,  242 
atrophy  of,  240 


Liver,  cirrhosis  of,  243 
congestion  of,  231 
diseases  of,  225 
.   examination,  225 
fatty,  241 
neoplasms  of,  244 
rupture  of,  246 
Lockjaw,  613 
Lungs,  cirrhosis  of,  57 
congestion  of,  49 
active,  49 
passive,  50 
diseases  of,  47 

examination,  47,  48,  49 
auscultation,  47,  48 
percussion,  49 
respiration,  47 
thorax,  47 
edema  of,  52 
gangrene  of,  58 
hyperemia  of,  49 
Luxation,  378 
of  eyeball,  550 
prognosis,  550 
treatment,  550,  551 
of  lens,  544 

treatment,  544 
Lymphadenitis,  120 
Lyssa,  603 


M 

MALFORMATIONS,     congenital,     of 

penis  and  prepuce,  265 
of  urethra,  425 
symptoms,  426 
treatment,  426 
of  vagina  and  vulva,  309 
of  teeth,  107 

treatment,  107 
Malignant  goiter,  342 
jaundice,  633 
neoplasms  of  eyelids,  508,  509 

of  mouth,  104 

tumors  of  mammary  glands,  318 
carcinoma ta,  318 
sarcomata,  318 
in  nasal  passages,  29 
Malposition  of  eyelids,  499 
blepharoptosis,  501 
blepharospasm,  503 
ectropion,  500 


050 


INDEX 


Malposition  of  eyelids,   ectropion, 

definition,  500 
etiology,  500 
prognosis,  500 
symptoms,  500 
treatment,  500,  501 
entropion,  499 
definition,  499 
etiology,  499 
prognosis,  499 
symptoms,  499 
treatment,  499,  500 
paralysis  of  orbicularis  nerve, 

502 

definition,  502 
etiology,  502 
prognosis,  502,  503 
symptoms,  502 
treatment,  503 
ptosis,  501 
definition,  501 
etiology,  501 
symptoms,  502 
treatment,  502 

spasm  of  orbicularis  nerve,  503 
definition,  503 
treatment,  503 
Mammary  glands,    congestion  of, 

316 
diseases  of,  315 

examination,  315 
tumors  of,  317 
wounds  and  injuries  of,  315 
Mammitis,  316 
definition,  310 
etiology,  310 
prognosis,  317 
symptoms,  310,  317 
treatment,  317 
Mange,  475 
definition,  475 
demodectic,  480 
diagnosis,  481 
etiology,  480 
pathology,  480 
prognosis,  481 
symptoms,  480,  481 
treatment,  481,  482 
etiology,  475,  476 
mites,  476 

demodex,  480 

folliculorum,  480 
sarcoptes,  476 


Mange,   mites,   sarcoptes    of  cat, 

477 
Sareoptes  minor,  var.  cati, 

477 
Notoedres  cati,   var.   cat, 

477 
of  dog,  476,  477 

Sarcoptes      scabiei,     var. 

canis,  476,  477 
of  ferret,  477,  478 

Sarcoptes     scabiei,     var. 

hydrochsri,  477,  478 
of  fowl,  478 

Cnemidocoptes      mutans, 

var.  gallinae,  478 
Sarcoptes  mutans,  478 
of  rabbit,  477 

Notaodres  cati,  var.  cuni- 

culi,  477 
Sarcoptes      minor,      var. 

cuniculi,  477 
red,  475 
sarcoptic,  475 
diagnosis,  478 
pathology,  476 
prognosis,  478 
treatment,  478,  479,  480 
Mastitis,  316 
Megrim,  457 

Meibomian  cyst  of  eyelids,  507 
Membrana  nictitans,  inflammation 

of,  522 

tumors  on,  523 
wounds  of,  523 
Membranous  enteritis,  190 
Meningo-encephalitis,  438 
definition,  43P,  439 
diagnosis,  440 
etiology,  439 
pathology,  439 
prognosis,  440 
symptoms,  439,  440 
treatment,  440 
Meningomyelitis,  443 
definition,  443 
diagnosis,  445 
etiology,  444 
pathology,  444 
prognosis,  445 
symptoms,  444,  445 
treatment,  445 
Menopum  biseriatum,  476 
trigonocephalum,  476 


INDEX 


657 


Metacarpal  and  phalangeal  bones, 

fracture  of,  373 
Metastrongulinse,  330 
Metritis,  293 
acute,  293 
definition,  293 
diagnosis,  295 
etiology,  293,  294 
pathology,  294,  295 
prognosis,  295 
symptoms,  295 
treatment,  295,  296 
chronic,  296 
definition,  296 
diagnosis,  298 
etiology,  296,- 297 
pathology,  297 
prognosis,  298 
symptoms,  297,  298 
treatment,  298 
definition,  293 
Moniezia  denticulata,  197 
Mouth,  benign  neoplasms  of,  102 
canker  of,  97 
diseases  of,  93 

examination,  93,  94 
abnormal  conditions  noted, 

93,  94 

foreign  bodies,  94 
mucous  membranes,  94 
neoplasms,  94 
odor,  93 

secretions,  93,  94 
foreign  bodies  in,  106 
malignant  neoplasms  of,  104 
sore,  96 
Multiceps  multicer-s,  196 

serialis,  196,  197 
Mumps,  115 

Muscular  rheumatism,  365 
Mycotic  pneumonia,  40 
Mydriasis,  539,  540 

definition,  539 
Myocarditis,  82 
acute,  82 
definition,  82 
diagnosis,  84 
etiology,  82,  83 
necropsy,  83 
prognosis,  84 
symptoms,  83,  84 
treatment,  84 
chronic,  84 
42 


Myocarditis,  chronic,  definition,  84 

etiology,  85 

necropsy,  85 
Myomata  of  uterus,  304 
Myosis,  540 
definition,  540 


N 


NASAL  catarrh,  acute,  19 
chronic,  23 
of  rabbits,  20,  21 
infectious,  20,  21 
parasitic,-  22 
passages,  diseases  of,  17 
examination,  17,  18 
abnormal  conditions  noted. 

18,  19 

discharge,  19 
foreign  bodies,  18 
hemorrhage,  18 
infectious,  18 
malformations,  18,  19 
parasites,  18 
tumors,  18 
neoplasms  of,  28 
benign  tumors,  28 
papillomata,  28 
treatment,  28 
polypoid  fibromata,  28 
treatment,  28,  29 
malignant  tumors,  29 
diagnosis,  29 
prognosis,  29 
symptoms,  29 
treatment,  29 
parasites  of,  25 
definition,  25 
diagnosis,  27 
etiology,  25 
life  cycle,  26 
necropsy,  27 
prognosis,  27 
symptoms,  27 
treatment,  27 
Nematoda,  201 
species,  201 
ascaridae,  201 
hookworm,  206 
round  worms,  201 

in  intestine  of  birds,  202, 
203 


058 


INDEX 


Ncmatoda,  species,  round  worms, 
in  intestine  of  cat, 
202 

of  dog,  202 
of  rabbit,  202 
strongylidse,  206 

in  intestine  of  cat,  207 
of  dog,  207 
of  rabbit,  207 
trichinellidse,  209,  210 
in  intestine  of  birds,  210 
of  dog,  210 
of  rabbit,  210 
whipworm,  209,  210 
Neoplasms  of  ear,  493 
cysts,  494 
papillomata,  493 
prognosis,  493 
symptoms,  493 
treatment,  493 
sebaceous  tumors,  494 

treatment,  494 
of  esophagus,  141 
diagnosis,  141 
prognosis,  141 
symptoms,  141 
treatment,  141 
of  eyelids,  508,  509 
of  liver,  244 
symptoms,  244 
treatment,  244 
of  mouth,  102 
benign,  102 
fibromata,  102 
symptoms,  103 
treatment,  103 
osteoma,  103 
symptoms,  103 
treatment,  103 
papillomata,  102 
symptoms,  102 
treatment,  102 
retention  cysts,  103 

treatment,  104 
malignant,  104 
epitheliomata,  104 
symptoms,  104,  105 
-treatment,  105 
sarcomata,  105 
symptoms,  105 
treatment,  105 
of  nasal  passages,  28 
of  pharynx,  128 


Neoplasms  of  pharynx,  epithelio- 
mata, 129 
symptoms,  129 
treatment,  129 
polypoid  growths,  128 
symptoms,  128 
treatment,  128 
in  rectum,  222 
diagnosis,  223 
prognosis,  223 
symptoms,  222,  223 
treatment,  223 
in  stomach,  165 
prognosis,  165 
symptoms,  165 
treatment,  165,  166 
Nephritis,  388 
acute,  388 
course,  392 
definition,  388,  389 
diagnosis,  391,  392 
etiology,  389,  390 
pathology,  390 
prognosis,  392 
symptoms,  391 
treatment,  392 
chronic,  392 
definition,  392,  393 
diagnosis,  395 
etiology,  393 
pathology,  393,  394 
prognosis,  395 
symptoms,  394,  395 
treatment,  396 
purulent,  396 
definition,  396 
diagnosis,  398 
etiology,  396,  397 
pathology,  397 
prognosis,  398 
symptoms,  397,  398 
treatment,  398 
Nephrolithiasis,  402 
Neuritis,  retrobulbar,  546,  547 
Non-inflammatory  ectasia  of   cor- 
nea, 538 
forms,  538 

keratoconus,  538 
keratoglobus,  538 
Non-suppurative  keratitis,  527 
forms,  526,  527 

keratitis  pigmentosa,  529 
punctata  profunda,  532 


INDEX 


659 


Non-suppurative   keratitis,  forms, 
keratitis  pig  mentosa, 
punctata  superficialis,  529 
parenchymatous,  530 
superficial,  527 
vascular,  528 
Nystagmus,  552 
definition,  552 
treatment,  553 


OBESITY,  352 
course,  353 
definition,  352 
etiology,  352,  353 
pathology,  353 
prognosis,  353 
symptoms,  353 
treatment,  353,  354 
Obstipation,  182 
Obstruction  of  crop  in  birds,  139 
definition,  139 
etiology,  139 
prognosis,  140 
symptoms,  139,  140 
treatment,  140,  141 
in  esophagus,  131 
intestinal,  182 
Occlusion  of  rectum  and  anus,  212, 

213 

artificial,  213 
congenital,  212,  213 
diagnosis,  213 
prognosis,  213 
symptoms,  213 
treatment,  213;  214 
of  urethra,  425 
Ollulanus  tricuspis  in  stomach    of 

cat,  163 

Oophorectomy,  285,  286 
in  cat,  289 

in  dog,  286,  287,  288,  289 
Oophoritis,  283 
Opacities  of  cornea,  536 
prognosis,  536 
treatment,  536,  537 
Optic  nerve,  atrophy  of,  547 
diseases  of,  546 
hemorrhages  of,  546 
inflammation  of,  546 
tumors  of,  546 


Optic  nerve,  wounds  of,  546 
Orbicularis  nerve,  paralysis  of,  502 

spasm  of,  503 
Orbit,  fracture  of,  553 

inflammation  of,  553 

tumors  of,  553 
Orchectomy,  273 
Orchitis,  271 

definition,  271 

etiology,  271,  272 

prognosis,  272 

symptoms,  272 

treatment,  272 
Osteoma  of  mouth,  103 
Osteomalacia,  362 
Otitis  externa,  490,  491 
diagnosis,  492 
etiology,  491 
prognosis,  492 
symptoms,  491,  492 
treatment,  492 

interna,  493 

media,  493 
Otorrhea,  490,  491 
Ovariectomy,  285,  286 
Ovaries,  diseases  of,  283 
examination,  283 

inflammation  of,  283 

tumors  of,  284  * 
Oxyuridae,  221 
Oxyuris  ambigua,  202,  222 

compar,  221 

vermicularis,  221 


PANNUS,  528 

Panophthalmitis,  548 
definition,  548 
diagnosis,  548,  549 
prognosis,  549 
symptoms,  548 
treatment,  549 

Papillitis,  546 
definition,  546 
prognosis,  546 

Papillomata  of  ear,  493 
of  eyelids,  506 
of  mouth,  102 
of  nasal  passages,  28 
of  penis  and  prepuce,  269 
of  vulva  and  vagina,  314 


660 


INDEX 


Paralysis,  infectious  bulbar,  611 
definition,  611 
diagnosis,  612 
etiology,  612 
natural  infection,  612 
pathogenicity,  612 
pathology,  612 
prognosis,  613 
symptoms,  612,  613 
treatment,  613 
of  orbicularis  nerve,  502 
of  peripheral  nerves,  450 
auditory,  453 
diagnosis,  454 
etiology,  453,  454 
prognosis,  454 
symptoms,  454 
treatment,  454 
brachial  plexus,  455 
etiology,  455 
prognosis,  456 
symptoms,  456 
treatment,  456 
facial,  450 
diagnosis,  451 
etiology,  450,  451 
prognosis,  451 
symptoms,  451 
treatment,  451,  452 
radial,  454 
diagnosis,  455 
etiology,  454,  455 
prognosis,  455 
symptoms,  455 
treatment,  455 
sciatic,  456 
etiology,  456 
prognosis,  456 
symptoms,  456 
treatment,  456 
trigeminal,  452 
diagnosis,  453 
etiology,  452 
prognosis,  453 
symptoms,  452,  453 
treatment,  453 
of  pharynx,  127 
Paraphimosis,  267 
definition,  267 
etiology,  267 
prognosis,  268 
symptoms,  268 
treatment,  268 


Parasites,  animal,  in  blood,  330 
Dirofilaria  immitis,  330 
diagnosis,  332 
etiology,  330,  331 
occurrence,  330 
pathogenesis,  331 
pathology,  331 
symptoms,  331,  332 
treatment,  332 
Filaria  immitis,  330 
Haemostrongylus    vasorum, 

332 

diagnosis,  333 
symptoms,  332 
treatment,  333 
Hema'tozoon  Lewisi,  332 
Spiroptera  sanguinolenta, 

333 

in  kidney,  407 
coccidia,  409 
Coccidium  tenellum,  409 
Cysticercus  cellulosae,  409 
Dioctophyme  renale,  407 
diagnosis,  409 
life  cycle,  408 
prognosis,  409 
symptoms,  408,  409 
treatment,  409 
Eimeria  avium,  409 
Eustrongylus  gigas,  407 
in  bladder,  423,  424 

Dioctophyme  renale,  423 
treatment,  424 
in  ear,  494 
diagnosis,  494 
prognosis,  494 
symptoms,  494 
treatment,  494 
of  eye,  553 
in  intestines,  193 
of  nasal  passages,  25 
in  rectum,  221 
Oxyuridse,  221 
Oxyuris  ambigua,  222 
compar,  221 
vermicularis,  221 
symptoms,  222 
treatment,  222 
in  scrotum  and  testes,  273 
in  stomach,  163 
of  birds,  163 

Dispharagus      n  a  s  u  t  u  s, 
163 


INDEX 


661 


Parasites  in  stomach  of  birds,  Dis- 

pharagus  spiralis,  163 
Trichosomum  contortum,163 
of  cat,  163 

Ollulanus  tricuspis,  163 
Taenia  tseniaeformis,  163 
diagnosis,  164 
of  dog,  163 

Gastrophilus  intestinalis,  163 
Spiroptera  sanguinolenta, 

163 

prognosis,  164 
of  rabbits,  163 

Strongylus  strigosus,  163 
symptoms,  164 
treatment,  165 
in  trachea  and  bronchial  tubes, 

42 
Parasitic  nasal  catarrh  of  birds,  22 

of  rabbits,  22 
stomatitis,  100 

Parenchymatous  conjunctivitis,514 
goiter,  336 
keratitis,  530 
Parotitis,  115 
definition,  115 
diagnosis,  117 
etiology,  115,  116 
pathology,  116 
prognosis,  117 
symptoms,  116,  117 
treatment,  117 
Passolurus  ambigus,  202 
Pasteurellosis  avium,  584 
Patella,  fracture  of,  375 
Patellar  dislocation,  382 
Pelvis,  fracture  of,  373,  374 
Penis  and  prepuce,  congenital  mal- 

formations  of,  265 
diseases  of,  263 

examination,  263 
tumors  of,  268 
wounds  of,  263,  264 
Pericarditis,  73 
definition,  73 
diagnosis,  75 
etiology,  73,  74 
necropsy,  74 
prognosis,  75 
symptoms,  75 
treatment,  75,  76 
Pericardium,  diseases  of,  69 

examination,  69,  70,  71,  72,  73 


Pericardium,   diseases  of,   exami- 
nation, heart,  71 
auscultation,  71,  72,  73 
endocardial  bruits,  72, 

73 

pericardial  bruits,  73 
palpation,  71 
percussion,  71 
pulse,  69,  70 
frequency,  69,  70 
quality,  70 
rhythm,  70 
dropsy  of,  76 
Pericementitis,  108 
Perineal  hernia,  563 
Periodontitis,  108 
Periostitis,  alveolar,  108 
definition,  108 
etiology,  108,  109 
pathology,  109 
symptoms,  109 
treatment,  109 
Peripheral  nerves,  compression  of, 

450 

injuries  of,  450 
paralysis  of,  450 
pressure  on,  450 
Peritoneum,  diseases  of,  248 

general  remarks,  248,  249 
Peritonitis,  250 
acute,  250 
course,  253,  254 
definition,  250 
diagnosis,  254 
etiology,  250,  251 
pathogenesis,  251 
pathology,  251,  252 
prognosis,  254    . 
symptoms,  252,  253 
treatment,  254,  255 
chronic,  255 
definition,  255 
diagnosis,  257 
etiology,  255,  256 
pathology,  256 
prognosis,  257 
symptoms,  256 
treatment,  257 
Pestus  avium,  489 
Phalangeal  dislocation,  381 
Pharyngitis,  123 
acute,  123 
definition,  123 


662 


INDEX 


Pharyngitis,  acute,  diagnosis,  124 
etiology,  123 
pathology,  124 
prognosis,  124 
symptoms,  124 
treatment,  125 
chronic,  125 
definition,  125 
etiology,  125 
pathology,  125 
prognosis,  125 
symptoms,  125 
treatment,  125,  126 
croupous,  of  birds,  127 
definition,  127 
etiology,  127 
pathology,  127 
prognosis,  128 
symptoms,  128 
treatment,  128 
Pharynx,  diseases  of,  123 

examination,  123 
foreign  bodies  in,  126 
neoplasms  of,  128 
paralysis  of,  127' 
Phimosis,  266 
definition,  266 
etiology,  266 
symptoms,  266,  267 
treatment,  267 
Phlegmonous  stomatitis,  99 
Phthiriasis,  474 
Pigmentary  keratitis,  529 
Piles,  216 

Pilosebaceous  cysts,  507 
Piropla-sma  bigeminum,  633 
canis,  633 
commune,  633 
Piroplasmosis  of  dog,  633 
definition,  633 
diagnosis,  635,  636 
etiology,  633,  634 
pathology,  634 
prognosis,  636 
symptoms,  634,  635 
treatment,  636 
Plague,  dog,  579 
fowl,  589 
rabbit,  20 

Pleura,  diseases  of,  60 
Pleurisy,  60 
Pleuritis,  60 
definition,  60 


Pleuritis,  diagnosis,  64 
etiology,  60,  61 
pathology,  61,  62 
prognosis,  64 
symptoms,  62,  63 
treatment,  64,  65 
Pneumonia,  catarrhal,  53 
chronic  interstitial,  57 
foreign  body,  58 
definition,  58 
diagnosis,  59 
etiology,  58,  59 
pathology,  59 
prognosis,  59 
symptoms,  59 
treatment,  59 
mycotic,  40 
definition,  40 
diagnosis,  41 
etiology,  40 
pathology,  40,  41 
prevention,  41 
prognosis,  41 
symptoms,  41 
treatment,  41 
Pneumothorax,  66 
definition,  66 
diagnosis,  67 
etiology,  66 
pathology,  66 
prognosis,  67 
symptoms,  67 
treatment,  67 
Podagra,  354 

Polyarthritis  rheumatica,  363 
Polypoid  fibromata  of   nasal  pas- 
sages, 28 

growths  of  pharynx,  128 
Poulardizing    the  female    chicken, 

289,  290 

Preputial  catarrh,  265 
Pressure  on  peripheral  nerves,  450 
Proctitis,  214 
definition,  214 
diagnosis,  215 
etiology,  214 
pathology,  214,  215 
prognosis,  215 
symptoms,  215 
treatment,  215 
Prolapse  of  rectum,  217 
definition,  217 
diagnosis,  218 


INDEX 


663 


Prolapse  of  rectum,  etiology,  217, 

218 

prognosis,  218,  219 
symptoms,  218 
treatment,  219,  220,  221 
of  uterus,  300 
of  vagina,  311 
diagnosis,  312 
etiology,  311 
prognosis,  312 
symptoms,  312 
treatment,  312,  313 
Prostate  gland,  diseases  of,  279 

examination,  279 
hypertrophy  of,  280 
tumors  of,  280 
Prostatitis,  279 
definition,  279 
etiology,  279 
prognosis,  280 
symptoms,  279,  280 
treatment,  280 

Pseudo-actinomycosis  of  dogs,  623 
definition,  623 
diagnosis,  624 
etiology,  623 
occurrence,  623 
pathogenicity,  623 
pathology,  623 
prognosis,  624 
symptoms,  623,  624 
treatment,  624 
Pseudoleukemia,  327 
definition,  327 
diagnosis,  327 
etiology,  327 
occurrence,  327 
pathology,  327 
prognosis,  327 
symptoms,  327 
treatment,  327 
Pseudorabies,  611 
Pterygium,  519 
definition,  519 
diagnosis,  519 
prognosis,  519 
symptoms,  519 
treatment,  519 
Ptosis,  501 

Puerperal  septicemia,  298 
definition,  298,  299 
diagnosis,  299,  300 
etiology,  299 


Puerperal    septicemia,    pathology, 

299 

prognosis,  300 
symptoms,  299 
treatment,  300 
Pulex  avium  of  birds,  472 
gonivcephalus  of  rabbits,  472 
irritans  of  man,  472 
Pulmonary  edema,  52 
definition,  52 
diagnosis,  53 
etiology,  52 
pathology,  52 
prognosis,  53 
symptoms,  52 
treatment,  53 

Purpura  hemprrhagica  of  dogs,  583 
Purulent  conjunctivitis,  512 
Pyelitis,  398 
definition,  398 
diagnosis,  399 
etiology,  398,  399 
pathology,  399 
prognosis,  399 
symptoms,  399 
treatment,  400 
Pyometra,  296 
Pyosalpinx,  291 


R 


RABBIT  distemper,  20 
influenza,  20 
plague,  20 
Rabies,  603 

course,  609,  610 
definition,  603 
diagnosis,  608 

differential,  610,  611 

confused  with  canine  dis- 
temper (nervous  form), 
610 

diseases  of  brain,  610 
eclampsia,  611 
epilepsy,  611 
foreign  bodies,  610 
infectiousbulbar  paralysis, 

611 
parasites     in      intestinal 

tract,  610 

trigeminal   or  facial  par- 
alysis, 610,  611 


664 


INDEX 


Rabies,  etiology,  603 
natural  infection,  604 
occurrence,  603 
pathogenesis,  604,  605 
pathogenicity,  603,  604 
pathology,  605 
preventive  inoculation,  611 
prognosis,  609,  610 
symptoms,  605,  606,  607 
treatment,  611 
Rachitis,  359 
course,  361 
definition,  359 
etiology,  359,  360 
occurrence,  359 
pathology,  360 
prognosis,  361 
svmptoms,  360,  361 
treatment,  361,  362 
Radial  nerve,  paralysis  of,  454 
Radio-ulnar-carpal  dislocation,  380 
Radius  and  ulna,  fracture  of,  372, 

373 

Ranula,  103 
Rectum  and  anus,  diseases  of,  212 

examination,  212 
neoplasms  in,  222 
occlusion  of,  212,  213 
parasites  in,  221 
prolapse  of,  217 
Red  itch,  482 
mange,  475 
Reflex  epilepsy,  459 
Renal  abscess,  397 

pelvis,  inflammation  of,  398 
Reproductive  organs,  diseases  of, 

263 

Retentio  urinae  vesicalis,  414 
Retention  cysts  in  mouth,  103 
of  scrotum  and  testes,  273 
of  urine  in  bladder,  414 
definition,  414 
diagnosis,  415 
etiology,  414 
prognosis,  415 
symptoms,  414,  415 
treatment,  415 

Retina  and  choroid,  diseases  of,  545 
pathological  changes,  545 
anemia,  545 
atrophy,  545 

detachment  of  retina,  545 
edema,  545 


Retina  and  choroid,   pathological 
changes,  hyperemia,  545 
inflammation  (retinitis), 

545 

Retrobulbar  neuritis,  546,  547 
Rheumatism,  363 
articular,  363 
course,  364 
definition,  363 
diagnosis,  364 
etiology,  363 
pathology,  363 
prognosis,  364,  365 
symptoms,  364 
treatment,  365 
muscular,  365 
course,  367 
definition,  365 
etiology,  365,  366 
pathology,  366 
prognosis,  367 
symptoms,  366,  367 
treatment,  367 
Rhinitis,  19 
chronic,  23 
coccidiosa,  22 

Rhipicephalus  sanguineus,  633 
Ribs,  fracture  of,  371 
Rickets,  359 
Ringworm,  482 

honeycomb,  484 
Roundworms,  201 
diagnosis,  204 

in  intestine  of  birds,  202,  203 
Heterakis  compressa,  203 
crassa,  203 
differens,  203 
P          dispar,  203 
inflexa,  203 
lineata,  203 
muculosa,  203 
papillosa,  202,  203 
perspicillum,  203 
vesicularis,  202,  203 
of  cat,  202 

Belascaris  mystax,  202 
of  dog,  202 

Belascaris  marginata,  202 
Echinorhynchus        canis, 

202 
Toxascaris  limbata,  202 

marginata,  202 
of  rabbit,  202 


INDEX 


665 


Roundworms  in  intestine  of  rabbit, 

Oxyuris  anibigua,  202 
Passolurus  ambigus,  202 
pathology,  293,  204 
prevention,  205,  206 
prognosis,  205 
symptoms,  204 
treatment,  205 
Roup,  593 

Ruptura  hepatis,  246 
Rupture  of  bladder,  412 

prognosis,  413 

symptoms,  412,  413 

treatment,  413 
of  heart,  92 

etiology,  92 

symptoms,  92 

treatment,  92 
of  liver,  246 

diagnosis,  246 

etiology,  246 

pathology,  246 

prognosis,  246,  247 

symptoms,  246 

treatment,  247 
of  uterus,  303 

prognosis,  303 

symptoms,  303 

treatment,  303 
of  vagina,  313 


SALIVARY  fistula,  118 
glands,  diseases  of,  115 

examination,  115 
Salpingitis,  291 
definition,  291 
etiology,  291 
symptoms,  291 
treatment,  291 
Sarcomata  of  bladder,  423 
of  eyelids,  509 
of  mammary  glands,  318 
of  mouth,  105 
of  penis  and  prepuce,  269 
of  scrotum  and  testes,  273 
of  vulva  and  vagina,  314 
Sarcoptes  mite,  476 
of  cat,  477 

Notcedres  cati,  var.  cati,  477 
Sarcoptes  minor,   var.  cati, 
477 


Sarcoptes  mite  of  dog,  476,  477 

Sarcoptes  scabiei,  var.  canis, 

478,  479 

of  ferret,  479,  480 
Sarcoptes  scabiei,  var.  hy- 

drochaeri,  477,  478 
of  fowl,  478 

Cnemidocoptes  mutans,  var. 

gallinse,  478 
Sarcoptes  mutans,  478 
of  rabbit,  477 
•  Notoedres  cati,  var.  cuniculi, 

477 

Sarcoptes  minor,  var.  cuni- 
culi, 477 
Scabies,  475 

Scapula,  fracture  of,  371 
Scapulohumeral  dislocation,  379 
Sciatic  nerve,  paralysis  of,  456 
Scorbutus,  328 
Scrotal  hernia,  561 
Scrotum,  diseases  of,  271 
parasites  in,  273 
tumors  of,  272 
wounds  and  injuries  of,  271 
Scurvy,  328 
definition,  328 
diagnosis,  329 
etiology,  328 
occurrence,  328 
pathology,  328,  329 
prognosis,  329,  330 
symptoms,  329 
treatment,  330 
Sebaceous  tumors  in  birds,  508 

of  ear,  494 

Secondary  epilepsy,  457 
Septicemia,  hemorrhagic,  of  cats, 

600 

puerperal,  298 

Simple  catarrh  of  stomach,  142 
Skin  diseases,  non-parasitic,  463 
examination,  463,  464 

microscopic,  463,  464 
parasitic,  472 

vegetable  482 
Soft  crop,  137 
Soor,  100 
Sore  mouth,  96 

Spasm  of  orbicularis  nerve,  503 
Spinal  cord,  compression  of,  448 
concussion  of,  445 
diseases  of,  443 


666 


INDEX 


Spinal  cord,  diseases  of,  examina- 
tion, 443 
general  considerations,  443 

functions  of  cord,  443 
injuries  of,  445 
Spirillosis  of  chickens,  625 
Spirochsetosis  avium,  625 
of  fowls,  625 
definition,  625 
diagnosis,  626 
etiology,  625 

natural  infection,  625,  626 
occurrence,  625 
pathogenesis,  625 
pathology,  626 
prognosis,  626 
symptoms,  626 
treatment,  626,  627 
Spiroptera  sanguinolenta,  333 

in  stomach  of  dog,  163 
Sprains  and  injuries  to    articula- 
tions, 377 
Staphyloma,  537 
Stenosis,  78 
Stomacace,  96 

Stomach,  chronic  catarrh  of,  146 
dilatation  of,  152 
acute,  152 
chronic,  154 
diseases  of,  142 

examination,  142 
foreign  bodies  in,  148 
neoplasms  in,  165 
parasites  in,  163 
simple  catarrh  of,  142 
ulceration  of,  157 
Stomatitis,  94 
catarrhal,  94 
definition,  94 
diagnosis,  95 
etiology,  94,  95 
pathology,  95 
prognosis,  96 
symptoms,  95 
treatment,  96 
fetid,  96 
gangrenous,  97 
definition,  97 
diagnosis,  98 
etiology,  97,  98 
pathology,  98 
prevention,  99 
prognosis,  98,  99 


Stomatitis,  gangrenous,  symptoms, 
98 

treatment,  99 
parasitic,  100 

definition,  100 

diagnosis,  101 

etiology,  100,  101 

pathology,  101 

prognosis,  101 

symptoms,  101 

treatment,  102 
phlegmonous,  99 

definition,  99 

diagnosis,  100 

etiology,  99 

pathology,  99 

prognosis,  100 

symptoms,  100 

treatment,  100 
ulcerative,  96 

definition,  96 

diagnosis,  97 

etiology,  96 

pathology,  96 

prognosis,  97 

symptoms,  96,  97 

treatment.  97 
Strabismus,  552 
definition,  552 
diagnosis,  552 
etiology,  552 
treatment,  552 
Streptotrichosis  canum,  623 
Stricture  of  esophagus,  135 

definition,  135 

etiology,  136 

prognosis,  136 

symptoms,  136 

treatment,  136 
of  urethra,  426 

definition,  426 

diagnosis,  427 

etiology,  427 

prognosis,  427 

symptoms,  427 

treatment,  427 
Strongylidse,  206 
diagnosis,  208 
in  intestine  of  cat,  207 

Ankylostomum  trigono- 
cephalum,  207 

of  dog,  207 

Ankylostomum  canina,  207 


INDEX 


667 


Strongylidae   in   intestine  of   dog, 
Ankylostomum    stenoce- 
phalum,  207 
Dochmius  trigonocephalus, 

207 
Uncinaria  stenocephala,  207 

trigonocephala,  207 
of  rabbit,  207 

Strongyloides  longus,  207 
Strongylus  strigosus,  207 
pathology,  208 
prognosis,  209 
symptoms,  208 
treatment,  209 
Strongyloides  longus,  207 
Strongylus  strigosus,  207 

in  stomach  of  rabbits,  163 
Struma,  336 
Submaxillary  andsublingual  glands, 

118 

Superficial  keratitis,  529 
Suppuration  of  anal  glands,223, 224 
diagnosis,  224 
treatment,  224 
Suppuratiye  hepatitis,  236 
keratitis,  532 
forms,  532 

abscess  of  cornea,  534 
keratitis  from  lagophthal- 

mos,  535 

neuroparalytica,  535 
ulceration  of  cornea,  532 
Symblepharon,  505 
Syngamosis,  42 
Synovial  membrane,  inflammation 

of,  383 
Synovitis,  383 


TABLE  of  equivalents   in   weights 

and  measures,  637 
Taenia,  camirus.  196 

crassicollis,  197 

cucumerina,  195 

echinococcus,  197 

elliptica,  197 

hydatigena,  196 

marginata,  196 

pisiformis,  195 

pseudo-elliptica,  197 

serialis,  190 


Tamia  serrata,  195,  196 

taeniaeformis  in  stomach  of  cat, 

193 
Taeniae,  193 

in  intestine  of  birds,  198 

Choanotaenia  infundibulifor- 

mis,  198 

Davainea  cesticillus,  198 
craswula,  198 
echinobothrida,  198 
proglottina,  198 
tetragona,  198 
Dicranotaenia  sphenoides, 

198 

Taenia  cantaniani,  198 
of  cats,  197 

Bothriocephalus  felis,  197 
Taenia  crassicollis,  197 
elliptica,  197 
pseudo-elliptica,  197 
taeniaeformis,  197 
of  dogs,  195 

Dipylidium  caninum,  195 
Echinococcus      granulosus, 

197 
Multiceps  multiceps,  196 

serialis,  196,  197 
Taenia  ccenurus,  196 
cucumerina,  195 
echinococcus,  197 
hydatigena,  196 
marginata,  196 
pisiformis,  195,  196 
serialis,  196,  197 
serrata,  195,  196 
of  rabbits,  197,  198 
Cittotaenia  denticulata,  197 
Moniezia  denticulata,  197 
life  history,  194,  195 
Taeniasis,  193,  194,  195 
in  birds,  198 
in  cats,  197 
diagnosis,  200 
in  dogs,  195 
pathology,  198,  199 
prognosis,  200 
in  rabbits,  197,  198 
symptoms,  199,  200 
treatment,  200,  201 
Tartar,  incrustations  of,  108 
Teeth,  caries  of,  109 
diseases  of,  107 
examination,  107 


668 


INDEX 


Teeth,  fractures  of,  108 
malformations  of,  107 
Teini>oroinaxillary  dislocation,  378 
Testes,  diseases  of,  271 
parasites  in,  273 
tumors  of,  272 
wounds  and  injuries  of,  271 
Tetanus,  613 

definition,  613,  614 
diagnosis,  614 
etiology,  614 
natural  infection,  614 
occurrence,  614 
pathology,  614 
prognosis,  615 
symptoms,  614,  615 
treatment,  615, 
Thrush,  100 
Thyroid  glands,  congestion  of,  334, 

335 

diseases  of,  334 
examination,  334 
general  considerations,  334 
Thyroiditis,  acute,  335 
definition,  335 
etiology,  335 
prognosis,  335 
symptoms,  335 
treatment,  335,  336 
Tibia  and  fibula,  fracture  of,  375 
Tibiotarsal  dislocation,  383 
Tongue,  diseases  of,  111 

examination,  111 
gangrene  of,  1 12 

Tonsillitis  and  lymphadenitis,  120 
definition,  120 
etiology,  120,  121 
pathology,  121 
prognosis,  121 
symptoms,  121 
treatment,  121,  122 
Tonsils,  diseases  of,  120 

examination,  120 
Torsion  of  bladder,  420 
of  cornua  uteri,  302 
symptoms,  302 
treatment,  302 
Toxascaris  limbata,  202 

marginata,  202 

Trachea  and  bronchial  tubes,  ani- 
mal parasites  in,  42 
definition,  42 
diagnosis,  43 


Trachea  and  bronchial  tubes,  ani- 
mal     parasites     in, 
etiology,  42 
prevention,  43 
prognosis,  43 
symptoms,  42,  43 
treatment,  43 
diseases  of,  34 

examination,  34 
Tracheitis  and  bronchitis,  34 
acute,  34 
definition,  34 
diagnosis,  37 
etiology,  34,  35,  36 
pathology,  36 
prognosis,  37 
symptoms,  36,  37 
treatment,  37,  38 
chronic,  44 
definition,  44 
diagnosis,  45 
etiology,  44 
pathology,  44 
prognosis,  45 
symptoms,  44,  45 
treatment,  45,  46 
Traumatic  lesions  of  conjunctiva, 

519 

foreign  bodies,  519,  520 
symptoms,  520 
treatment,  520 
wounds,  520 

treatment,  520,  521 
Trichiasis,  503 

definition,  503,  504 
prognosis,  504 
symptoms,  504 
treatment,  504 
Trichinellidse,  209,  210 
diagnosis,  211 

in  intestine  of  birds,  210,  211 
Trichosomum  annulatum, 

210 

brevicolle,  211 
collare,  210 
retusum,  210 
tennissimum,  211 
of  dog,  210 

Trichuris  depressiusculus, 

210 
of  rabbit,  210 

Trichurus  unguiculatus,  210 
pathology,  211 


INDEX 


669 


Trichinellidse,  prognosis,  211 
symptoms,  211 
treatment,  211 
Trichodectes  latus,  474 

subrostratus,  474 
Trichosomum  annulatum,  210 
brevicolle,  211 
collare,  210 
contortum,  163 

in  stomach  of  birds,  163 
retusum,  210 
tennissimum,  211 
Trichurus  depressiusculus,  210 

unguiculatus,  210 
Trigeminal  nerve,  paralysis  of,  451 
Tuberculomata  of  eyelids,  511 
Tuberculosis,  avian,  616 
avium,  616 
of  birds,  616 
definition,  616 
diagnosis,  619 
etiology,  616 
natural  infection,  617 
occurrence,  616 
pathogenesis,  616,  617 
pathology,  617,  618 
prevention,  620 
prognosis,  620 
symptoms,  618,  619 
treatment,  620 
of  dogs  and  cats,  620 
diagnosis,  622 
form,  620 
occurrence,  620 
pathogenesis,  621 
pathology,  621 
prognosis,  622 
symptoms,  621,  622 
treatment,  622 
Tumors  of  bladder,  423 
prognosis,  423 
treatment,  423 
varieties,  423 
carcinomata,  423 
fibromata,  423 
sarcomata,  423 
of  brain,  441,  442 
symptoms,  442 
on  conjunctiva,  522 

treatment,  522 
of  cornea,  538 

treatment,  538 
of  ear,  493 


Tumors  of  eyelids,  506 
varieties,  506 
chalazion,  507 

treatment,  507 
cysts,  meibomian,  507 

pilosebaceous,  507 
enlargement  of  glands  of 

Moll,  508 
treatment,  508 
granulomas,  508 
treatment,  508 
lipoma  in  birds,  508 
treatment,  508 
malignant  neoplasms,    508, 

509 

diagnosis,  509 
treatment,  509 
varieties,  509 
carcinomata,  509 
epitheliomata,  509 
sarcomata,  509 
tuberculomata,  509 
Meibomian  cysts,  507 
papillomata,  506 

treatment,  506,  507 
pilosebaceous  cysts,  507 

treatment,  508 
sebaceous,  in  birds,  508 
warts,  506 
of  iris,  541 
in  kidney,  407 

treatment,  407 
in  nasal  passages,  29 
benign,  28 
malignant,  29 
of  mammary  glands,  317 
benign,  317 
fibromata,  317 
prognosis,  318 
symptoms,  318 
treatment,  318 
lipoma,  318 
prognosis,  318 
symptoms,  318 
treatment,  318 
malignant,  318 
carcinomata,  318 
prognosis,  318 
symptoms,  318 
treatment,  318 
sarcomata,  318 
diagnosis,  318 
symptoms,  318 


070 


INDEX 


Tumors  of  mammary  glands,  ma- 
lignant, sarcomata,  treatment, 
318 

on  membrana  nictitans,  523 
of  orbit,  553 
of  ovaries,  284 
varieties,  284 
cysts,  284 
diagnosis,  285 
prognosis,  285 
treatment,  285 
other  tumor  formations,  285 
of  penis  and  prepuce,  268 
varieties,  269,  270 
carcinomata,  269 
epitheliomata,  269 
papillomata,  269 
symptoms,  269 
treatment,  269 
sarcomata,  269 
diagnosis,  269 
symptoms,  269 
treatment,  269 
venereal  granulomata,  269 
diagnosis,  270 
prognosis,  270 
symptoms,  269,  270 
treatment,  270 
of  prostate  gland,  280 
diagnosis,  281 
prognosis,  281 
symptoms,  281 
treatment,  281,  282 
of  scrotum  and  testes,  272 
carcinomata,  273 
fibromata,  272,  273 
retention  cysts,  273 
sarcomata,  273 
treatment,  273 
of  uterine  tubes,  291 
of  uterus,  303 

fibromata,  303,  304 
diagnosis,  304 
prognosis,  304 
symptoms,  304 
treatment,  304 
hydrometra,  304 
definition,  304 
diagnosis,  305 
etiology,  304,  305 
prognosis,  305 
symptoms,  305 
treatment,  305 


Tumors  of  uterus,  myomata,  304 
of  vulva  and  vagina,  313 
fibromata,  313 
diagnosis,  313 
prognosis,  313 
treatment,  314 
papillomata,  314 
treatment,  314 
sarcomata,  314 

treatment,  314 
venereal  granulomata,  314 

treatment,  314 
Typhoid,  fowl,  584 
Typhus,  canine,  579 
of  dogs,  579 
course,  582 
definition,  579 
diagnosis,  581,  582 
etiology,  579 
occurrence,  579 
pathology,  579,  580 
prognosis,  582 
symptoms,  580,  581 
treatment,  582,  583 


ULCERATION  of  concha,  488 
etiology,  488 
prognosis,  489 
symptoms,  489 
treatment,  489 
of  conjunctiva,  521 

treatment,  521 
of  cornea,  532 
of  stomach,  157 
definition,  157,  158 
diagnosis,  159 
etiology,  158 
pathology,  158 
prognosis,  159 
symptoms,  158,  159 
treatment,  159 
Ulcerative  stomatitis,  96 
Ulcus  yentriculi,  157 
Umbilical  hernia,  557 
Uncinaria  stenocephala,  207 

trigonocephala,  207 
Uremia,  400 
definition,  400 
diagnosis,  401 
etiology,  400 


INDEX 


671 


Uremia,  prognosis,  401 
symptoms,  400 
treatment,  401,  402 
Urethra,  calculi  in,  427 

congenital  malformations  of,  425 
diseases  of,  425 

examination,  425 
inflammation  of,  429 
occlusion  of,  425 
stricture  of,  426 
wounds  of,  .426 
Urethritis,  429 
symptoms,  429 
treatment,  429 
Urine,  incontinence  of,  in  bladder, 

416 

retention  of,  in  bladder,  414 
Urocystitis,  416 
Uterine  tubes,  cysts  of,  291 
diseases  of,  291 

examination,  291 
tumors  of,  291 
Uterus,  diseases  of,  292 

examination,  292,  293 
eversion  of,  300 
inversion  of,  300 
prolapse  of,  300 
rupture  of,  303 
tumors  of,  303 


VAGINA,  diseases  of,  309 

examination,  309 
malformations,  congenital,  309 
prolapse  of,  311 
rupture  of,  313 
tumors  of,  313 
and  vulva,  309 

congenital    malformations  of, 

309 

Vaginitis  and  vulvitis,  309 
definition,  309 
diagnosis,  311 
etiology,  310 
prognosis,  311 
symptoms,  310 
treatment,  311 
Valvular  insufficiency  and  stenosis, 

78 

definition,  78,  79 
insufficiency,  78,  79 


Valvular  insufficiency  and  stenosis, 

definition,  insufficiency, 

imperfect      closing     of 

valves,  78,  79 

stenosis  or  contraction  of 

openings,  79 
diagnosis,  81 
etiology,  79 
necropsy,  80 
prognosis,  81 
symptoms,  80,  81 
treatment,  81,  82 
Vascular  goiter,  341 

keratitis,  528 
Vegetable  parasitic  disease  of  skin, 

482 
Venereal  granulomata  of  penis  and 

prepuce,  269 
of  vulva  and  vagina,  314 
Ventral  hernia,  558 
Vertebrae,  fracture  of,  370 
Vertebral  dislocation,  379 
Vertigo,  455 
definition,  455 
diagnosis,  456 
etiology,  455 
prognosis,  456 
symptoms,  455,  456 
treatment,  456 
Volvulus,  185  . 
definition,  185 
diagnosis,  185,  186 
etiology,  185 
pathology,  185 
prognosis,  186 
symptoms,  185 
treatment,  186 
Vulva,  diseases  of,  309 
examination,  309 
tumors  of,  313 
Vulvitis,  309 


W 

WARTS  on  eyelids,  506 
Whipworm,  209,  210 
White  comb,  484 

diarrhea,  629 
Wounds  of  articulations,  376 

of  bladder,  412 

on  conjunctiva,  520 

of  cornea,  535 


072  INDEX 

Wounds  of  ear,  487,  488  ;  Wounds  of  intestines,  188 

prognosis,  488  definition,  188 

symptoms,  488  etiology,  188 

treatment,  488  symptoms,  188,  189 

of  eyelids,  497,  498  treatment,  189 
and  injuries  of  mammary  gland       of  membrana  m'ctitans,  523 

315  of  penis  and  prepuce,  263,  264 

treatment,  315  prognosis,  264 

of  testes  and  scrotum,  271  symptoms,  264 

prognosis,  271  treatment,  264,  265 

symptoms,  271  of  urethra,  426 

treatment,  271  treatmert,  426 


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